Individual provider Active NPI

Ines Russo Suarez, DMD

  • Dentist
  • Mayaguez, PR
National Provider Identifier
1275675761
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1518 Issued in PR
Practice address
Migrant Health Center, Inc.
392 Sur Carr Ramon Emeterio Betances
Mayaguez, PR 00680
Phone
(787) 805-2900
Fax
(787) 834-1924
NPI assigned
Feb 13, 2007
Sex
Female
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
Dentist 122300000X 1518 PR Primary

Addresses

Primary practice location

Migrant Health Center, Inc.
392 Sur Carr Ramon Emeterio Betances
Mayaguez, PR 00680

Mailing address

Migrant Health Center, Inc.
P O Box 7128
Mayaguez, PR 00681-7128
Phone (787) 805-2900

Other identifiers 1

IdentifierTypeStateIssuer
1187OtherPRNUM COLEGIADO

Other names 1

  • Dr. Ines Russo Suarez Former name

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
I20151230000098 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0042512543

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1518PRMDNutritionist

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275675761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MIGRANT HEALTH CENTER, INC.",
            "address_2": "P O BOX 7128",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006817128",
            "telephone_number": "787-805-2900",
            "fax_number": "787-834-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MIGRANT HEALTH CENTER, INC.",
            "address_2": "392 SUR CARR RAMON EMETERIO BETANCES",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-805-2900",
            "fax_number": "787-834-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAREZ",
        "first_name": "INES",
        "middle_name": "RUSSO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "1518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NUM COLEGIADO",
            "identifier": "1187",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "INES",
            "last_name": "SUAREZ",
            "middle_name": "RUSSO",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.