Provider Demographics
NPI:1730129388
Name:JIMENEZ, ARHIMAZDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARHIMAZDA
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1499
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-1499
Mailing Address - Country:US
Mailing Address - Phone:787-263-1277
Mailing Address - Fax:787-864-0189
Practice Address - Street 1:CALLE ASHFORD #125
Practice Address - Street 2:ASHFORD MEDICAL PLAZA SUITE 204
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-866-6406
Practice Address - Fax:787-864-0189
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23151223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics