1568272045 NPI number — ANA KAREN BENCOSME DDS

Table of content: ANA KAREN BENCOSME DDS (NPI 1568272045)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568272045 NPI number — ANA KAREN BENCOSME DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BENCOSME
Provider First Name:
ANA
Provider Middle Name:
KAREN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DDS
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:
1568272045
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7 C. CERVANTES
Provider Second Line Business Mailing Address:
EL QUIJOTE, 601
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00907
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
267-810-8151
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MEDICAL SCIENCE CAMPUS
Provider Second Line Business Practice Location Address:
UNIVERSITY OF PUERTO RICO
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
267-810-8151
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/08/2025

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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