Active NPI
Mario J Herrera, DMD
- Dentist
- Cayey, PR
National Provider Identifier
1013138973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2648
- Practice address
- 52 Ave Baldorioty W
Cayey, PR 00736-3837 - Phone
- (787) 738-8955
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2648 | PR | Primary |
Addresses
Primary practice location
52 Ave Baldorioty W
Cayey, PR 00736-3837
Mailing address
PO Box 30132
San Juan, PR 00929-1132
Phone (939) 969-1255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4350966 | Other | PR | DRIVER LICENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101215000338 | TX | Practitioner - Oral Surgery | 1658568704 | Practice locations: Wagner, SD |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2648 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233014400000",
"number": "1013138973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30132",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009291132",
"telephone_number": "939-969-1255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52 AVE BALDORIOTY W",
"city": "CAYEY",
"state": "PR",
"postal_code": "007363837",
"telephone_number": "787-738-8955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRERA",
"first_name": "MARIO",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2009-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PR",
"license": "2648",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER LICENCE",
"identifier": "4350966",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cayey, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; 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.