Provider Demographics
NPI:1487712261
Name:ORTIZ-DIAZ, NADGIE (DMD)
Entity type:Individual
Prefix:DR
First Name:NADGIE
Middle Name:
Last Name:ORTIZ-DIAZ
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 1:914 VIA PINTADA
Mailing Address - Street 2:HACIENDA SAN JOSE
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:787-529-1777
Mailing Address - Fax:787-653-5208
Practice Address - Street 1:AA1 AVE DON PELAYO
Practice Address - Street 2:URB. COVADONGA
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-5388
Practice Address - Country:US
Practice Address - Phone:787-798-8589
Practice Address - Fax:787-785-8589
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR25141223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry