Provider Demographics
NPI:1689747172
Name:ORTIZ, YASLIN C (DMD)
Entity Type:Individual
Prefix:DR
First Name:YASLIN
Middle Name:C
Last Name:ORTIZ
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:VILLAS MONTE ATENAS 1300 CALLE ATENAS
Mailing Address - Street 2:APARTAMENTO 702
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7811
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AVE. PONCE DE LEON EDIF 1801 PARADA 26
Practice Address - Street 2:SUITE 405
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-726-0440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR27531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice