Individual provider Active NPI

Daniel E Rodriguez

  • General Practice Dentistry
  • Guaynabo, PR
National Provider Identifier
1255418232
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1992 Issued in PR
Practice address
12A Calle Buen Samaritano
Gardenville
Guaynabo, PR 00966-7933
Phone
(787) 783-0783
Fax
(787) 783-1502
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

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 1992 PR Primary

Addresses

Primary practice location

12A Calle Buen Samaritano
Gardenville
Guaynabo, PR 00966-7933

Mailing address

12A Calle Buen Samaritano
Gardenville
Guaynabo, PR 00966-7933
Phone (787) 783-0783

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
I20171219001362 PR Order and Referring Only - DentistPractitioner - Dentist 5496013583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1992PRMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health and Wellness LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255418232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12A CALLE BUEN SAMARITANO",
            "address_2": "GARDENVILLE",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009667933",
            "telephone_number": "787-783-0783",
            "fax_number": "787-783-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12A CALLE BUEN SAMARITANO",
            "address_2": "GARDENVILLE",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009667933",
            "telephone_number": "787-783-0783",
            "fax_number": "787-783-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "DANIEL",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.