Provider Demographics
NPI:1780658799
Name:ORTIZ, JORGE RAMOS (DMD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:RAMOS
Last Name:ORTIZ
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 71 BOX 2939
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-9768
Mailing Address - Country:US
Mailing Address - Phone:787-859-5837
Mailing Address - Fax:
Practice Address - Street 1:RR 6 BOX 7591
Practice Address - Street 2:
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-9622
Practice Address - Country:US
Practice Address - Phone:787-870-5225
Practice Address - Fax:787-870-5308
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice