Active NPI
Roberto Velazquez
- Oral and Maxillofacial Surgery (Dentist)
- Zelienople, PA
National Provider Identifier
1356904734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- DS045665
- Practice address
- 506 S Main St Ste 2101
Zelienople, PA 16063-1604 - Phone
- (724) 452-9153
- NPI assigned
- Apr 21, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DS045665 | PA | Primary |
Addresses
Primary practice location
506 S Main St Ste 2101
Zelienople, PA 16063-1604
Mailing address
506 S Main St Ste 2101
Zelienople, PA 16063-1604
Phone (724) 452-9153
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 15, 2025 through Jul 15, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Center for Oral, Maxillofacial & Implant Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Oral and Maxillofacial Surgery (Dentist)
- Evanston, IL
- NPI 1205095387
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787616000000",
"number": "1356904734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 S MAIN ST STE 2101",
"city": "ZELIENOPLE",
"state": "PA",
"postal_code": "160631604",
"telephone_number": "724-452-9153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 S MAIN ST STE 2101",
"city": "ZELIENOPLE",
"state": "PA",
"postal_code": "160631604",
"telephone_number": "724-452-9153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELAZQUEZ",
"first_name": "ROBERTO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-21",
"last_updated": "2026-08-25",
"certification_date": "2026-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "PA",
"license": "DS045665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Zelienople, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.