Active NPI
Rene A Dietrich Trigo, DMD
- General Practice Dentistry
- San Juan, PR
National Provider Identifier
1225010812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2179
- Practice address
- 576 Calle Cesar Gonzalez
San Juan, PR 00918-3756 - Phone
- (787) 282-0709
- Fax
- (800) 878-2948
- NPI assigned
- Nov 18, 2005
- Sex
- Male
- Sole proprietor
- No
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 | 2179 | PR | Primary |
Addresses
Primary practice location
576 Calle Cesar Gonzalez
San Juan, PR 00918-3756
Mailing address
35 Juan D Borbon 67
PMB 144
Guaynabo, PR 00969
Phone (787) 282-0709
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42129 | Other | PR | TRIPLE S INC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2179 | PR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225010812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 JUAN D BORBON 67",
"address_2": "PMB 144",
"city": "GUAYNABO",
"state": "PR",
"postal_code": "00969",
"telephone_number": "787-282-0709",
"fax_number": "800-878-2958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "576 CALLE CESAR GONZALEZ",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009183756",
"telephone_number": "787-282-0709",
"fax_number": "800-878-2948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETRICH TRIGO",
"first_name": "RENE",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PR",
"license": "2179",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIPLE S INC",
"identifier": "42129",
"state": "PR"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.