Eliseo Roman, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

1034 Issued in PR

Practice address

Road 164 Ramal KM. 0.2
Box 924
Naranjito, PR 00719-0924

Phone

(787) 299-9377

Fax

(787) 869-5333

NPI assigned

May 18, 2006

Last updated

Oct 23, 2024By the provider in NPPES

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

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1174576367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 924",
            "city": "NARANJITO",
            "state": "PR",
            "postal_code": "007190924",
            "telephone_number": "787-299-9377",
            "fax_number": "787-869-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROAD 164 RAMAL KM. 0.2",
            "address_2": "BOX 924",
            "city": "NARANJITO",
            "state": "PR",
            "postal_code": "007190924",
            "telephone_number": "787-299-9377",
            "fax_number": "787-869-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "ELISEO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "1034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria Rodriguez
• Luz Zorybell Rodriguez, M.D.
• Mireilys Rodriguez, LND
• Rosaly Rodriguez, MS SLP
• Analiris Roman Garland, MS
• Jessica Raquel Roman
• Liz S Romero Marrero
• Lizmarie Rosado Rivera
• Giean Mari Rosado
• Nereida Rosario

• Dentist in Naranjito, PR
• Providers in Naranjito, PR by specialty
• Dentist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.