Provider Demographics
NPI:1447223482
Name:LAMBOY, JORGE (DMD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:
Last Name:LAMBOY
Suffix:
Gender:M
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:NS7 AVE HOSTOS
Mailing Address - Street 2:SANTA JUANITA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-5102
Mailing Address - Country:US
Mailing Address - Phone:787-785-8887
Mailing Address - Fax:
Practice Address - Street 1:NS7 AVE HOSTOS
Practice Address - Street 2:SANTA JUANITA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-5102
Practice Address - Country:US
Practice Address - Phone:787-785-8887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3718Medicare UPIN