Active NPI
Angelita C Olazabal, D.M.D.
- Endodontics
- Guaynabo, PR
National Provider Identifier
1154403608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 1940
- Practice address
- Plaza Suchville
Suite 207
Guaynabo, PR 00966 - Phone
- (787) 782-0590
- NPI assigned
- Oct 20, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 1940 | PR | Primary |
Addresses
Primary practice location
Plaza Suchville
Suite 207
Guaynabo, PR 00966
Mailing address
99 Carr 2
Ste 207
Guaynabo, PR 00966-2047
Phone (787) 793-5724
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 |
|---|---|---|---|---|
| I20160127001639 | PR | Order and Referring Only - Oral Surgery | 6103129002 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1940 | PR | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452988800000",
"number": "1154403608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 CARR 2",
"address_2": "STE 207",
"city": "GUAYNABO",
"state": "PR",
"postal_code": "009662047",
"telephone_number": "787-793-5724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PLAZA SUCHVILLE",
"address_2": "SUITE 207",
"city": "GUAYNABO",
"state": "PR",
"postal_code": "00966",
"telephone_number": "787-782-0590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLAZABAL",
"first_name": "ANGELITA",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-20",
"last_updated": "2016-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "PR",
"license": "1940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Guaynabo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.