Provider Demographics
NPI:1659367795
Name:HANKE HERRERO, ROSANA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROSANA
Middle Name:
Last Name:HANKE HERRERO
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 1:100 AVE LA SIERRA
Mailing Address - Street 2:APT 9A
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4316
Mailing Address - Country:US
Mailing Address - Phone:787-293-5067
Mailing Address - Fax:787-293-5067
Practice Address - Street 1:576 TNT CESAR GONZALES AVE.
Practice Address - Street 2:SUITE 307
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-753-1475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24721223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
26168OtherAMERICAN HEALTH
7899OtherINTERNATIONAL MEDICAL IMC
40291 HAOtherSEGUROS DE SERVICIOS SSS
9180469OtherHUMANA REFORMA
9180469OtherHUMANA INSURANCE
043097OtherLA CRUZ AZUL DE PR
237026OtherPREFERRED HEALTH
1595628OtherUNITED CONCORDIA