Provider Demographics
NPI:1497425359
Name:IRIZARRY, ANDRES NEFTALI (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:NEFTALI
Last Name:IRIZARRY
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:HC 1 BOX 3548
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-9018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:351 AVE HOSTOS STE 214
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-1503
Practice Address - Country:US
Practice Address - Phone:787-806-2442
Practice Address - Fax:787-806-2444
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR33951223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics