Provider Demographics
NPI:1992814198
Name:ARIZMENDI, NELSON (DMD)
Entity type:Individual
Prefix:
First Name:NELSON
Middle Name:
Last Name:ARIZMENDI
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:PO BOX 1043
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-1043
Mailing Address - Country:US
Mailing Address - Phone:787-899-6225
Mailing Address - Fax:
Practice Address - Street 1:HP16 CALLE AMALIA PAOLI
Practice Address - Street 2:7MA SECCION LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-3606
Practice Address - Country:US
Practice Address - Phone:787-784-0282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1546122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist