Active NPI
Victor L Acevedo, DMD,MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- San Juan, PR
National Provider Identifier
1033212501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 864
- Practice address
- Los Flamboyanes Shopping Ctr
Of.12, 65TH de Infanteria
San Juan, PR 00923-3306 - Phone
- (787) 758-1560
- Fax
- (787) 758-1513
- NPI assigned
- Sep 7, 2006
- Last updated
- Jul 8, 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 864 | PR | Primary |
Addresses
Primary practice location
Los Flamboyanes Shopping Ctr
Of.12, 65TH de Infanteria
San Juan, PR 00923-3306
Mailing address
Los Flamboyanes Shopping Ctr
Of.12, 65TH de Infanteria
San Juan, PR 00923-3306
Phone (787) 758-1560
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8817007 | Other | PR | UNITED CONCORDIA |
| 42261 | Other | PR | TRIPLE S, INC |
| 040376 | Other | PR | CRUZ AZUL DE PR |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 864 | PR | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033212501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "LOS FLAMBOYANES SHOPPING CTR",
"address_2": "OF.12, 65TH DE INFANTERIA",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009233306",
"telephone_number": "787-758-1560",
"fax_number": "787-758-1513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "LOS FLAMBOYANES SHOPPING CTR",
"address_2": "OF.12, 65TH DE INFANTERIA",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009233306",
"telephone_number": "787-758-1560",
"fax_number": "787-758-1513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACEVEDO",
"first_name": "VICTOR",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DMD,MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "PR",
"license": "864",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "8817007",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIPLE S, INC",
"identifier": "42261",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRUZ AZUL DE PR",
"identifier": "040376",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.