Provider Demographics
NPI:1902011984
Name:ARIZMENDI, OVIDIO JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:OVIDIO
Middle Name:
Last Name:ARIZMENDI
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 LA SERRANIA
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-1806
Mailing Address - Country:US
Mailing Address - Phone:787-744-8330
Mailing Address - Fax:
Practice Address - Street 1:57 CALLE SANTIAGO N
Practice Address - Street 2:
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-2426
Practice Address - Country:US
Practice Address - Phone:787-737-7450
Practice Address - Fax:787-737-7450
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR002170122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist