Individual provider Active NPI

Benjamin Perez Febles, D.D.S.

  • General Practice Dentistry
  • Mayaguez, PR
National Provider Identifier
1053527374
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2732 Issued in PR
Practice address
55 Calle Dr Basora N
Office # 105, Medico IV
Mayaguez, PR 00680-4810
Phone
(787) 834-3863
Fax
(787) 805-5440
NPI assigned
May 15, 2007
Sex
Male
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
General Practice Dentistry 1223G0001X 2732 PR Primary

Addresses

Primary practice location

55 Calle Dr Basora N
Office # 105, Medico IV
Mayaguez, PR 00680-4810

Mailing address

55 Calle Dr Basora N
Office # 105, Medico IV
Mayaguez, PR 00680-4810
Phone (787) 834-3863

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180621002645 PR Order and Referring Only - DentistPractitioner - Dentist 2567717101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2732PRMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Smiles of Beauty Dental Group, P.S.C. General Practice 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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053527374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CALLE DR BASORA N",
            "address_2": "OFFICE # 105, MEDICO IV",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006804810",
            "telephone_number": "787-834-3863",
            "fax_number": "787-805-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CALLE DR BASORA N",
            "address_2": "OFFICE # 105, MEDICO IV",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006804810",
            "telephone_number": "787-834-3863",
            "fax_number": "787-805-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ FEBLES",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.