Individual provider Active NPI

Francisco Javier Moreda, DMD

  • General Practice Dentistry
  • Manati, PR
National Provider Identifier
1235138231
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1562 Issued in PR
Practice address
82 Calle McKinley
Manati, PR 00674-5377
Phone
(787) 884-0417
Fax
(787) 884-0417
NPI assigned
Jul 20, 2005
Reactivated
Mar 28, 2006
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 1562 PR Primary

Addresses

Primary practice location

82 Calle McKinley
Manati, PR 00674-5377

Mailing address

82 Calle McKinley
Manati, PR 00674-5377
Phone (787) 884-0417

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
I20150730012079 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4880908169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1562PRMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1235138231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 CALLE MCKINLEY",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006745377",
            "telephone_number": "787-884-0417",
            "fax_number": "787-884-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 CALLE MCKINLEY",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006745377",
            "telephone_number": "787-884-0417",
            "fax_number": "787-884-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOREDA",
        "first_name": "FRANCISCO",
        "middle_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2026-07-13",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.