Provider Demographics
NPI:1851481956
Name:VELEZ, DIEGO (DMD)
Entity Type:Individual
Prefix:DR
First Name:DIEGO
Middle Name:
Last Name:VELEZ
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 1:34 CALLE PARQUE
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-6129
Mailing Address - Country:US
Mailing Address - Phone:787-785-0335
Mailing Address - Fax:787-785-0335
Practice Address - Street 1:34 CALLE PARQUE
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6129
Practice Address - Country:US
Practice Address - Phone:787-785-0335
Practice Address - Fax:787-785-0335
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice