Individual provider Active NPI

Daniel Soto Soto, DMD

  • General Practice Dentistry
  • Gurabo, PR
National Provider Identifier
1316614647
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3393 Issued in PR
Practice address
H5 Urb.Prociosa
Gurabo, PR 00778
Phone
(787) 432-2708
NPI assigned
Aug 25, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3393 PR Primary

Addresses

Primary practice location

H5 Urb.Prociosa
Gurabo, PR 00778

Mailing address

PO Box 800485
Coto Laurel, PR 00780-0485
Phone (787) 432-2708

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
I20211112002288 PR Practitioner - Dentist 3870982895 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3393PRMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Servicios Dentales DDS, LLC General Practice CurrentSince Oct 21, 2021 Accepting new patients
Dr. Lino LLC Single Specialty CurrentSince Feb 24, 2022 Accepting new patients
Bright Smiles Dental Services DMD LLC General Practice PastSince Mar 12, 2024 Accepting new patients

Locations

2053 Ponce Byp
Ste 101
Ponce, PR 00717
Phone (787) 812-1010

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1316614647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800485",
            "city": "COTO LAUREL",
            "state": "PR",
            "postal_code": "007800485",
            "telephone_number": "787-432-2708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "H5 URB.PROCIOSA",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "00778",
            "telephone_number": "787-432-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO SOTO",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "3393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurabo, PR

Sources for this page

Verify at the official NPI Registry.