Provider Demographics
NPI:1083671630
Name:ORTIZ APONTE, JOHANA (DMD)
Entity Type:Individual
Prefix:
First Name:JOHANA
Middle Name:
Last Name:ORTIZ APONTE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8761
Mailing Address - Street 2:PLAZA CAROLINA STATION
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00988-8761
Mailing Address - Country:US
Mailing Address - Phone:787-757-7988
Mailing Address - Fax:787-769-7340
Practice Address - Street 1:SUITE 30 ALTOS LA PLAZOLETA
Practice Address - Street 2:PLAZA CAROLINA MALL
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00988
Practice Address - Country:US
Practice Address - Phone:787-757-7988
Practice Address - Fax:787-769-7340
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2012-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20341223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics