Individual provider Active NPI

Susana Angelica Quinquilla, DENTIST

  • General Practice Dentistry
  • Vega Baja, PR
National Provider Identifier
1184606972
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1118 Issued in PR
Practice address
Calles Jose Julian Acosta
62B Vega Baja
Vega Baja, PR 00063
Phone
(787) 855-5336
NPI assigned
Nov 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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 1118 PR Primary

Addresses

Primary practice location

Calles Jose Julian Acosta
62B Vega Baja
Vega Baja, PR 00063

Mailing address

Calle Jose Julian Acosta
62B Vega Baja
Vega Baja, PR 00063
Phone (787) 855-5336

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
I20150916000323 PR Order and Referring Only - DentistPractitioner - Dentist 9739336652

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1118PRMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jamonpsc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1184606972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE JOSE JULIAN ACOSTA",
            "address_2": "62B VEGA BAJA",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "00063",
            "telephone_number": "787-855-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLES JOSE JULIAN ACOSTA",
            "address_2": "62B VEGA BAJA",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "00063",
            "telephone_number": "787-855-5336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINQUILLA",
        "first_name": "SUSANA",
        "middle_name": "ANGELICA",
        "name_prefix": "Dr.",
        "credential": "DENTIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Baja, PR

Sources for this page

Verify at the official NPI Registry.