1164976809 NPI number — DR. MARIA M IRIZARRY TOLEDO DMD

Table of content: DR. MARIA M IRIZARRY TOLEDO DMD (NPI 1164976809)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164976809 NPI number — DR. MARIA M IRIZARRY TOLEDO DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
IRIZARRY TOLEDO
Provider First Name:
MARIA
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164976809
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
RR 2 BOX 4056
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOA ALTA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00953-7003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-243-1737
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 164 KM 9.6
Provider Second Line Business Practice Location Address:
SECTOR EL DESVIO
Provider Business Practice Location Address City Name:
NARANJITO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00957
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-243-1737
Provider Business Practice Location Address Fax Number:
787-869-1800
Provider Enumeration Date:
08/11/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  3286 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com