Jose Ivan Maldonado, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

1778 Issued in PR

Practice address

48 Calle Teodomiro Ramirez
Vega Alta, PR 00692-6518

Phone

(787) 883-2030

Fax

(787) 270-2908

NPI assigned

Jan 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1104897479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CARR 2",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006926069",
            "telephone_number": "787-883-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 CALLE TEODOMIRO RAMIREZ",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006926518",
            "telephone_number": "787-883-2030",
            "fax_number": "787-270-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "JOSE",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "1778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Los Pinos Nursing Home, Inc
• LRN Dental Services LLC
• Macro Health Care
• Macro Orthopedic Corp
• Joisemarie Maldonado Pabon, MSW
• Zenaida Maldonado, PHARMACIST
• Diane Louise Mankin Cruz, MD
• Claudia Mansito-Lopez, MD
• Jose Rolando Marcano Perez, DC
• Yaritza Marcano

• Dentist in Vega Alta, PR
• Providers in Vega Alta, PR by specialty
• Dentist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.

Verify at the official NPI Registry.