Active NPI
Raymond Ortiz Class, DMD
- General Practice Dentistry
- Carolina, PR
National Provider Identifier
1376540013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2523
- Practice address
- Roberto Clemente Ave
24 8 Villa Carolina
Carolina, PR 00985-5401 - Phone
- (787) 757-3080
- Fax
- (787) 757-1910
- NPI assigned
- Jul 7, 2005
- Reactivated
- Apr 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2523 | PR | Primary |
Addresses
Primary practice location
Roberto Clemente Ave
24 8 Villa Carolina
Carolina, PR 00985-5401
Mailing address
Ave Roberto Clemente
24 8 Villa Carolina
Carolina, PR 00985-5401
Phone (787) 757-3080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2523 | Other | PR | MEDICAL LICENCES |
Other names 1
- Dr. Ortiz Class Raymond
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160504000016 | PR | Order and Referring Only - Other (Non-Physician) | 6608175211 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2523 | PR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605830400000",
"number": "1376540013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "AVE ROBERTO CLEMENTE",
"address_2": "24 8 VILLA CAROLINA",
"city": "CAROLINA",
"state": "PR",
"postal_code": "009855401",
"telephone_number": "787-757-3080",
"fax_number": "787-757-1910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ROBERTO CLEMENTE AVE",
"address_2": "24 8 VILLA CAROLINA",
"city": "CAROLINA",
"state": "PR",
"postal_code": "009855401",
"telephone_number": "787-757-3080",
"fax_number": "787-757-1910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ CLASS",
"first_name": "RAYMOND",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-07",
"last_updated": "2020-11-20",
"certification_date": "2020-11-20",
"deactivation_date": "2006-03-21",
"reactivation_date": "2006-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PR",
"license": "2523",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENCES",
"identifier": "2523",
"state": "PR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ORTIZ",
"last_name": "RAYMOND",
"middle_name": "CLASS",
"prefix": "DR.",
"credential": "DMD",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Carolina, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.