Individual provider Active NPI

Raul A Delgado, D.M.D

  • General Practice Dentistry
  • San Juan, PR
National Provider Identifier
1285645887
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2503 Issued in PR
Practice address
U3-12 Carr 21
Las Lomas
San Juan, PR 00921-3313
Phone
(787) 792-0303
Fax
(787) 792-0303
NPI assigned
Aug 10, 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 2503 PR Primary

Addresses

Primary practice location

U3-12 Carr 21
Las Lomas
San Juan, PR 00921-3313

Mailing address

11 Calle Opalo
Chalets de Santa Clara
Guaynabo, PR 00969-6855
Phone (787) 792-0303

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
I20170105001693 PR Order and Referring Only - DentistPractitioner - Dentist 0749561728

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2503PRMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285645887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CALLE OPALO",
            "address_2": "CHALETS DE SANTA CLARA",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009696855",
            "telephone_number": "787-792-0303",
            "fax_number": "787-792-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "U3-12 CARR 21",
            "address_2": "LAS LOMAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009213313",
            "telephone_number": "787-792-0303",
            "fax_number": "787-792-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADO",
        "first_name": "RAUL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.