Rafael Diaz Mendez, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

1052 Issued in PR

Practice address

400 Ave FD Roosevelt
Suite 502
San Juan, PR 00918

Phone

(787) 756-5252

Fax

(787) 763-4928

NPI assigned

Aug 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285742189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "A17 CALLE PALMA SOLA",
            "address_2": "GARDEN HILLS SUR",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009662923",
            "telephone_number": "787-781-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 AVE FD ROOSEVELT",
            "address_2": "SUITE 502",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-756-5252",
            "fax_number": "787-763-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ MENDEZ",
        "first_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PR",
            "license": "1052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC. #",
            "identifier": "1052",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juan J Diaz Hernandez, M.D.
• Sara Marie Diaz Jimenez
• Giovannie Miguel Diaz Lopez, CRNA
• Ricardo Diaz Marmolejos
• Jorge A Diaz Martinez, D.C.
• Silvino Diaz Mendoza, MD
• Karen Diaz Miranda, RN
• Carlos Antonio Diaz Montes, PHARM D
• Abneris Diaz Morales, LND
• Bruny Vanessa Diaz Moreno, M.D

• Periodontics in San Juan, PR
• Providers in San Juan, PR by specialty
• Periodontics 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.