=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962954818
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NATALIA VANESSA RAMIREZ RODRIGUEZ D.M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2016
-----------------------------------------------------
Last Update Date | 04/09/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 EXT CALLE SOL
-----------------------------------------------------
City | SAN GERMAN
-----------------------------------------------------
State | PUERTO RICO
-----------------------------------------------------
Zip | 00683
-----------------------------------------------------
Country | UM
-----------------------------------------------------
Telephone | 787-264-5437
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | R3 CALLE CEDRO URB VALLE HERMOSO NORTE
-----------------------------------------------------
City | HORMIGUEROS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00660-1403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 3235
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------