Provider Demographics
NPI:1437540697
Name:VELEZ ORTHODONTICS, INC.
Entity Type:Organization
Organization Name:VELEZ ORTHODONTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HERNAN
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-786-0025
Mailing Address - Street 1:PO BOX 1468
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-1468
Mailing Address - Country:US
Mailing Address - Phone:787-786-0025
Mailing Address - Fax:787-786-0060
Practice Address - Street 1:RD 2 #1845
Practice Address - Street 2:BAYAMON MEDICAL PLAZA SUITE 801
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-786-0025
Practice Address - Fax:787-786-0060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8881223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty