Rafael A. Gavilanes - Mendez, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

3250 Issued in PR

Practice address

1005 Ave General Ramey Ste 1
San Antonio, PR 00690

Phone

(787) 510-0912

NPI assigned

Nov 3, 2014

Sex

Male

Sole proprietor

Yes

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

State licenses

Practice roles

Locations

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.

• Recinto de Ciencias Medicas

  • Oral & Maxillofacial Surgery (D.M.D.)
  • San Juan, PR
  • NPI 1205868676
  Medicare reassignment NPD
• Bajalu, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • San Antonio, PR
  • NPI 1144813551
  NPD
• Recinto de Ciencias Medicas

  • Colon & Rectal Surgery Physician
  • San Juan, PR
  • NPI 1538935051
  NPD
• Departamento de Salud Oficial

  • General Acute Care Hospital
  • Rio Piedras, PR
  • NPI 1407859036
  NPD (past)
• FDG Servicios Dentales, PSC

  • General Practice Dentistry
  • San Antonio, PR
  • NPI 1134282304
  NPD (past)
• Gpa Surgical PR LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Mayaguez, PR
  • NPI 1619864790
  NPD (past)
• Wisco Oral Surgery LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Aibonito, PR
  • NPI 1407535214
  NPD (past)

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

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1154726131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 784",
            "city": "SAN ANTONIO",
            "state": "PR",
            "postal_code": "006900784",
            "telephone_number": "787-510-0912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 AVE GENERAL RAMEY STE 1",
            "city": "SAN ANTONIO",
            "state": "PR",
            "postal_code": "00690",
            "telephone_number": "787-510-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVILANES - MENDEZ",
        "first_name": "RAFAEL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-03",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PR",
            "license": "3250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Javier Burgos Medina
• Yasmin Burgos
• Clinica Terapeuta Dra Valentin LLC
• Maria Louisa Crespo, MT(ASCP)
• FDG Servicios Dentales, PSC
• Dalia Iveliz Gonzalez Malave, MD
• Yamilette Gonzalez, MSW
• Francisco Guevara, D.M.D.
• Natalia Guevara, DMD
• Lourdes Hernandez

• Oral and Maxillofacial Surgery (Dentist) in San Antonio, PR
• Providers in San Antonio, PR by specialty
• Oral and Maxillofacial Surgery (Dentist) in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.