Individual provider Active NPI

Elaine M. Pagan, D.M.D.

  • Pediatric Dentistry
  • Rio Piedras, PR
National Provider Identifier
1053458323
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
1865 Issued in PR
Practice address
Marginal Sein
Carretera #1 KM 16.1
Rio Piedras, PR 00927
Phone
(787) 756-6125
Fax
(787) 756-6125
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 1865 PR Primary

Addresses

Primary practice location

Marginal Sein
Carretera #1 KM 16.1
Rio Piedras, PR 00927

Mailing address

PO Box 1527
Trujillo Alto, PR 00977-1527
Phone (787) 756-6125

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
1865PRMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sonrisas Hermosas, CSP Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053458323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1527",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009771527",
            "telephone_number": "787-756-6125",
            "fax_number": "787-756-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARGINAL SEIN",
            "address_2": "CARRETERA #1 KM 16.1",
            "city": "RIO PIEDRAS",
            "state": "PR",
            "postal_code": "00927",
            "telephone_number": "787-756-6125",
            "fax_number": "787-756-6125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGAN",
        "first_name": "ELAINE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PR",
            "license": "1865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Piedras, 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.

Verify at the official NPI Registry.