Active NPI
Reinaldo E. Deliz-Guzman, D.M.D.
- Periodontics
- San Juan, PR
National Provider Identifier
1194067827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 3193
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240305002713 | PR | Order and Referring Only - Oral Surgery | 5597060988 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3193 | PR | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guaynabo Periodontics and Dental Implants | Periodontics | Current | 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.
-
- Periodontics
- San Juan, PR
- NPI 1568237543
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.