Active NPI
Brenda Rivera Davila, DMD
- General Practice Dentistry
- Luquillo, PR
National Provider Identifier
1114060217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2204
- Practice address
- Condominio Playa Azul IV
Local Comercial G03
Luquillo, PR 00773 - Phone
- (787) 889-4390
- Fax
- (787) 889-6554
- NPI assigned
- Feb 15, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2204 | PR | Primary |
Addresses
Primary practice location
Condominio Playa Azul IV
Local Comercial G03
Luquillo, PR 00773
Mailing address
PO Box 523
Luquillo, PR 00773
Phone (787) 889-4390
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160824001860 | PR | Order and Referring Only - Oral Surgery | 0446545834 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2204 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114060217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 523",
"city": "LUQUILLO",
"state": "PR",
"postal_code": "00773",
"telephone_number": "787-889-4390",
"fax_number": "787-889-6554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CONDOMINIO PLAYA AZUL IV",
"address_2": "LOCAL COMERCIAL G03",
"city": "LUQUILLO",
"state": "PR",
"postal_code": "00773",
"telephone_number": "787-889-4390",
"fax_number": "787-889-6554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA DAVILA",
"first_name": "BRENDA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PR",
"license": "2204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Luquillo, PR
- Puerto Rico Primary Care Mso, Inc. - Radiologia
- Puerto Rico Primary Care, Mso, Inc. - Laboratorio
- Elinette Ramirez, R. PH.
- Angeles Margarita Ramos, PH
- Maria Reynoso, PSY.D.
- Jomarie Rivera Irizarry, MD
- Edgardo Rivera Rodriguez
- Virginia Selenia Rivera-Santiago
- Angelica Maria Rivera
- Cynthia Odaly Robles Perez
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.