Individual provider Active NPI

Jaime Rafael Gierbolini, DMD

  • General Practice Dentistry
  • Coamo, PR
National Provider Identifier
1174660575
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
958 Issued in PR
Practice address
49 Calle Jose I Quinton
Coamo, PR 00769-2448
Phone
(787) 825-1660
Fax
(787) 825-1660
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 958 PR Primary

Addresses

Primary practice location

49 Calle Jose I Quinton
Coamo, PR 00769-2448

Mailing address

49 Calle Jose I Quinton
Coamo, PR 00769-2448
Phone (787) 825-1660

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160505001739 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0446559876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
958PRMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174660575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 CALLE JOSE I QUINTON",
            "city": "COAMO",
            "state": "PR",
            "postal_code": "007692448",
            "telephone_number": "787-825-1660",
            "fax_number": "787-825-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 CALLE JOSE I QUINTON",
            "city": "COAMO",
            "state": "PR",
            "postal_code": "007692448",
            "telephone_number": "787-825-1660",
            "fax_number": "787-825-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIERBOLINI",
        "first_name": "JAIME",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coamo, PR

Sources for this page

Verify at the official NPI Registry.