Individual provider Active NPI

Marta M Garcia Cerra, DMD

  • Dentist
  • San Juan, PR
National Provider Identifier
1245314095
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1625 Issued in PR
Practice address
124 Ave Winston Churchill
Suite #3 Crown Hill Rio Piedras
San Juan, PR 00926-6064
Phone
(787) 765-8176
Fax
(787) 765-8476
NPI assigned
Oct 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Dentist 122300000X 1625 PR Primary

Addresses

Primary practice location

124 Ave Winston Churchill
Suite #3 Crown Hill Rio Piedras
San Juan, PR 00926-6064

Mailing address

Urb Los Maestros 212 la Hija del Caribe
Hato Rey, PR 00918
Phone (787) 765-8176

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
I20160908001413 PR Order and Referring Only - DentistPractitioner - Dentist 9739475369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1625PRMDRehabilitation Counselor

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245314095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB LOS MAESTROS 212 LA HIJA DEL CARIBE",
            "city": "HATO REY",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-765-8176",
            "fax_number": "787-765-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 AVE WINSTON CHURCHILL",
            "address_2": "SUITE #3 CROWN HILL RIO PIEDRAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266064",
            "telephone_number": "787-765-8176",
            "fax_number": "787-765-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA CERRA",
        "first_name": "MARTA",
        "middle_name": "M",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "1625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.