Individual provider Active NPI

Lizvette Ortiz, DENTIST

  • General Practice Dentistry
  • Cabo Rojo, PR
National Provider Identifier
1255428892
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2476 Issued in PR
Practice address
Carretera 100 KM 5.8 Int #2300
Barrio Miradero
Cabo Rojo, PR 00623
Phone
(787) 255-0065
Fax
(787) 255-0065
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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 2476 PR Primary

Addresses

Primary practice location

Carretera 100 KM 5.8 Int #2300
Barrio Miradero
Cabo Rojo, PR 00623

Mailing address

PO Box 930
Cabo Rojo, PR 00623-0930
Phone (787) 255-0065

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
I20160318001868 PR Order and Referring Only - DentistPractitioner - Dentist 2264739234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2476PRMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1255428892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 930",
            "city": "CABO ROJO",
            "state": "PR",
            "postal_code": "006230930",
            "telephone_number": "787-255-0065",
            "fax_number": "787-255-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 100 KM 5.8 INT #2300",
            "address_2": "BARRIO MIRADERO",
            "city": "CABO ROJO",
            "state": "PR",
            "postal_code": "00623",
            "telephone_number": "787-255-0065",
            "fax_number": "787-255-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "LIZVETTE",
        "name_prefix": "Mrs.",
        "credential": "DENTIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cabo Rojo, PR

Sources for this page

Verify at the official NPI Registry.