Active NPI
Jose Gustavo Wiscovitch, D.M.D., M.S
- Endodontics
- Aguadilla, PR
National Provider Identifier
1174511844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 1385
- Practice address
- Ave. Pedro Albizu Campos # 2022
Aguadilla, PR 00603 - Phone
- (787) 891-9155
- Fax
- (787) 882-8050
- NPI assigned
- Oct 7, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 1385 | PR | Primary |
| Oral and Maxillofacial Pathology Dentistry | 1223P0106X | 1385 | PR |
Addresses
Primary practice location
Ave. Pedro Albizu Campos # 2022
Aguadilla, PR 00603
Mailing address
P.O. Box 8053 Marina Station
Mayaquez, PR 00681
Phone (787) 891-9155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1385 | PR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370304000000",
"number": "1174511844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 8053 MARINA STATION",
"city": "MAYAQUEZ",
"state": "PR",
"postal_code": "00681",
"telephone_number": "787-891-9155",
"fax_number": "787-882-8050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "AVE. PEDRO ALBIZU CAMPOS # 2022",
"city": "AGUADILLA",
"state": "PR",
"postal_code": "00603",
"telephone_number": "787-891-9155",
"fax_number": "787-882-8050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISCOVITCH",
"first_name": "JOSE",
"middle_name": "GUSTAVO",
"name_prefix": "Dr.",
"credential": "D.M.D., M.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-07",
"last_updated": "2013-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "PR",
"license": "1385",
"primary": true
},
{
"code": "1223P0106X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Pathology",
"state": "PR",
"license": "1385",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aguadilla, PR
- Westen Primary Group CSP
- Westmar LLC Dba Farmacia Ramey
- William Colon Villanueva HNC Colon Ambulance Service
- Wisco Russo LLC
- Alejandro Javier Wiscovitch Russo, DMD
- Y & M Medical Services
- Yanelly Rosa (Laboratorio Clinico Bet-El)
- Yo Cuido Mi Salud Mental LLC
- Karen Vanessa Yulfo Acevedo
- Yeidy Marie Yulfo Badillo
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.