Individual provider Active NPI

Ronald Ayala, DDS

  • General Practice Dentistry
  • Fort Pierce, FL
National Provider Identifier
1013260033
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN5138 Issued in FL
Practice address
714 Avenue C
Fort Pierce, FL 34950-4189
Phone
(772) 462-3874
NPI assigned
Oct 16, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN5138 FL Primary

Addresses

Primary practice location

714 Avenue C
Fort Pierce, FL 34950-4189

Mailing address

5150 NW Milner Dr
Port St Lucie, FL 34983-3392
Phone (772) 462-3874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN5138FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1013260033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 NW MILNER DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349833392",
            "telephone_number": "772-462-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 AVENUE C",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504189",
            "telephone_number": "772-462-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYALA",
        "first_name": "RONALD",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-16",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN5138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.