Active NPI
Marie Rosa Aviles Aviles, DMD
- General Practice Dentistry
- Toa Alta, PR
National Provider Identifier
1205904182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1886
- Practice address
- Toa Alta Heights Mini Mall
Ave. Principal BLQ. M1-D
Toa Alta, PR 00953-0897 - Phone
- (787) 797-0550
- Fax
- (787) 799-2110
- NPI assigned
- Dec 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1886 | PR | Primary |
Addresses
Primary practice location
Toa Alta Heights Mini Mall
Ave. Principal BLQ. M1-D
Toa Alta, PR 00953-0897
Mailing address
PO Box 897
Bayamon, PR 00960-0897
Phone (787) 797-0550
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 |
|---|---|---|---|---|
| I20160615001424 | PR | Order and Referring Only - Dentist | 4688965015 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1886 | PR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205904182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 897",
"city": "BAYAMON",
"state": "PR",
"postal_code": "009600897",
"telephone_number": "787-797-0550",
"fax_number": "787-799-2100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "TOA ALTA HEIGHTS MINI MALL",
"address_2": "AVE. PRINCIPAL BLQ. M1-D",
"city": "TOA ALTA",
"state": "PR",
"postal_code": "009530897",
"telephone_number": "787-797-0550",
"fax_number": "787-799-2110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVILES AVILES",
"first_name": "MARIE",
"middle_name": "ROSA",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PR",
"license": "1886",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Toa Alta, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.