Pedro Fuentes Lopez

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

665 Issued in PR

Practice address

Ave. Casa Linda Num. 1 Suite 101
Entrada American Military Academy
Bayamon, PR 00959

Phone

(787) 789-1919

Fax

(787) 731-0357

NPI assigned

Sep 5, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255433587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 509",
            "address_2": "P.O.BOX 7891",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009707891",
            "telephone_number": "787-789-1919",
            "fax_number": "787-731-0597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. CASA LINDA NUM. 1 SUITE 101",
            "address_2": "ENTRADA AMERICAN MILITARY ACADEMY",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-789-1919",
            "fax_number": "787-731-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES LOPEZ",
        "first_name": "PEDRO",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "40035",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bianca Gisselle Freire
• Maria I. Freire, OD
• Angelica Milady Fuentes Armesto, MD, DABFM
• Marangelis Fuentes Emmanuelli, PT
• Ariana N Fuentes Lopez, PHARMD
• Lourdes M. Fuentes Rivera, PT.
• Fransis Fuentes, PHARMACY TECH
• Jasmin Fuentes, MSW
• Functional Restoration PSC
• Fuss Orthopedics, Inc.

• General Practice Dentistry in Bayamon, PR
• Providers in Bayamon, PR by specialty
• General Practice Dentistry in Puerto Rico

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.