Individual provider Active NPI

Reinaldo E. Deliz-Guzman, D.M.D.

  • Periodontics
  • San Juan, PR
National Provider Identifier
1194067827
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
3193 Issued in PR
Practice address
1900 Ave. Jesus T. Pineiro, Suite 5
Marginal Expreso Martinez Nadal
San Juan, PR 00920
Phone
(787) 402-3746
Fax
(787) 834-3006
NPI assigned
Mar 20, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3193 PR
Student in an Organized Health Care Education/Training Program 390200000X
Periodontics 1223P0300X 3193 PR Primary

Addresses

Primary practice location

1900 Ave. Jesus T. Pineiro, Suite 5
Marginal Expreso Martinez Nadal
San Juan, PR 00920

Mailing address

1900 Ave. Jesus T. Pineiro, Suite 5
Marginal Expreso Martinez Nadal
San Juan, PR 00920
Phone (787) 402-3746

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
I20240305002713 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5597060988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3193PRMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Guaynabo Periodontics and Dental Implants Periodontics CurrentSince Nov 26, 2023 Accepting new patients

Locations

1910 Ave Jesus T Pinero
Ste 205
San Juan, PR 00921
Phone (787) 402-3746

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1194067827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 AVE. JESUS T. PINEIRO, SUITE 5",
            "address_2": "MARGINAL EXPRESO MARTINEZ NADAL",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00920",
            "telephone_number": "787-402-3746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 AVE. JESUS T. PINEIRO, SUITE 5",
            "address_2": "MARGINAL EXPRESO MARTINEZ NADAL",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00920",
            "telephone_number": "787-402-3746",
            "fax_number": "787-834-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELIZ-GUZMAN",
        "first_name": "REINALDO",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "3193",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PR",
            "license": "3193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.