Individual provider Active NPI

Angel F Olivero, DMD

  • General Practice Dentistry
  • Fajardo, PR
National Provider Identifier
1194715458
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
824 Issued in PR
Practice address
161 Calle Cielo
Fajardo, PR 00738-5127
Phone
(787) 863-4918
Fax
(787) 863-5997
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 824 PR Primary

Addresses

Primary practice location

161 Calle Cielo
Fajardo, PR 00738-5127

Mailing address

PO Box 1281
Fajardo, PR 00738-1281
Phone (787) 863-4918

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
I20151001002898 PR Order and Referring Only - DentistPractitioner - Dentist 3173831633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
824PRMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1194715458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1281",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007381281",
            "telephone_number": "787-863-4918",
            "fax_number": "787-863-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 CALLE CIELO",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007385127",
            "telephone_number": "787-863-4918",
            "fax_number": "787-863-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVERO",
        "first_name": "ANGEL",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fajardo, PR

Sources for this page

Verify at the official NPI Registry.