Individual provider Active NPI

Sandra I Renta Llop, DMD

  • General Practice Dentistry
  • San Sebastian, PR
National Provider Identifier
1205974037
Registry record updated Jul 8, 2007
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1566 Issued in PR
Practice address
Jose Mendez Cordona St
#3 Office 208
San Sebastian, PR 00685
Phone
(787) 896-6040
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1566 PR Primary

Addresses

Primary practice location

Jose Mendez Cordona St
#3 Office 208
San Sebastian, PR 00685

Mailing address

PO Box 1668
San Sebastian, PR 00685
Phone (787) 896-6040

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
I20240409002915 PR Practitioner - Dentist 7911296215 Practice locations: San Sebastian, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1566PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205974037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1668",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "00685",
            "telephone_number": "787-896-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JOSE MENDEZ CORDONA ST",
            "address_2": "#3 OFFICE 208",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "00685",
            "telephone_number": "787-896-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTA LLOP",
        "first_name": "SANDRA",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Sebastian, PR

Sources for this page

Verify at the official NPI Registry.