Jose A Davila-Collazo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19868 Issued in NJ

Practice address

12 Banic St
Ste 203
Summit, NJ 07901

Phone

(908) 273-2080

Fax

(908) 273-2087

NPI assigned

Sep 6, 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

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Metro Medical Dental Associates Inc.

  • General Practice Dentistry
  • Bayamon, PR
  • NPI 1447420419
  NPD (past)

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295838340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BANIC ST",
            "address_2": "STE 203",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "07901",
            "telephone_number": "908-273-2080",
            "fax_number": "908-273-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 BANIC ST",
            "address_2": "STE 203",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "07901",
            "telephone_number": "908-273-2080",
            "fax_number": "908-273-2087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA-COLLAZO",
        "first_name": "JOSE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "19868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luciana Silberman Daniels, DDS
• Jodie Darling, M.S. RD
• Datchi Psychology and Consulting LLC
• Corinne Cecile Datchi, PHD, ABPP
• Nicole Rohinton Daver, DO
• Joanne Erin Davine-Reicher, M.D
• Lawrence De Angelis, MD
• Ellen De Havilland, MT-BC
• Jayakanthi Dealwis, M.D.
• Stephen T. Deats, MSW, LCSW

• General Practice Dentistry in Summit, NJ
• Providers in Summit, NJ by specialty
• General Practice Dentistry in New Jersey

• 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.