Active NPI
Dora Emanuelli, DMD
- Periodontics
- Ponce, PR
National Provider Identifier
1275658684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 1925
- Practice address
- 2914 Ave Emilio Fagot
Ponce
Ponce, PR 00716-3611 - Phone
- (787) 841-2881
- Fax
- (787) 840-7726
- NPI assigned
- Mar 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 1925 | PR | Primary |
Addresses
Primary practice location
2914 Ave Emilio Fagot
Ponce
Ponce, PR 00716-3611
Mailing address
2914 Ave Emilio Fagot
Ponce
Ponce, PR 00716-3611
Phone (787) 841-2881
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1925 | PR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275658684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2914 AVE EMILIO FAGOT",
"address_2": "PONCE",
"city": "PONCE",
"state": "PR",
"postal_code": "007163611",
"telephone_number": "787-841-2881",
"fax_number": "787-840-7726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2914 AVE EMILIO FAGOT",
"address_2": "PONCE",
"city": "PONCE",
"state": "PR",
"postal_code": "007163611",
"telephone_number": "787-841-2881",
"fax_number": "787-840-7726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMANUELLI",
"first_name": "DORA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "PR",
"license": "1925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponce, PR
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.