Vidal Antonio Perez, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D1592 Issued in PR

Practice address

#5 Ave. Los Veteranos
Guayama, PR 00784

Phone

(787) 864-4222

Fax

(787) 864-8029

NPI assigned

Mar 1, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013045210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GUAYAMA DENTAL CENTER",
            "address_2": "PO BOX 2190",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "007852190",
            "telephone_number": "787-864-4222",
            "fax_number": "787-864-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#5 AVE. LOS VETERANOS",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "00784",
            "telephone_number": "787-864-4222",
            "fax_number": "787-864-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "VIDAL",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "D1592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Carmen Pardo, MSW
• Armando Luis Perez de Jesus, MD
• Ruben A Perez Ramirez, M,D
• Leroy A Perez, MD
• Ruben Armando Perez, MD
• PHM Multidisciplinary Clinic LLC
• Picart Health Services PSC.
• Zinnia Enid Picart, M.D.
• Jose Lucas Pimentel Fernandez, M.D.
• PMC Marketing Corp

• General Practice Dentistry in Guayama, PR
• Providers in Guayama, PR by specialty
• General Practice Dentistry in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.