Individual provider Active NPI

Jose Rivera Ayala, DMD

  • General Practice Dentistry
  • Villalba, PR
National Provider Identifier
1376629576
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
950 Issued in PR
Practice address
23 Calle Barcelo
Villalba, PR 00766-2230
Phone
(787) 847-4410
Fax
(787) 847-2946
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 950 PR Primary

Addresses

Primary practice location

23 Calle Barcelo
Villalba, PR 00766-2230

Mailing address

Jardines de Ponce
B3 Calle a
Ponce, PR 00730-1816
Phone (787) 844-4173

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
I20160523001135 PR Order and Referring Only - DentistPractitioner - Dentist 6709175235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
950PRMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376629576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "JARDINES DE PONCE",
            "address_2": "B3 CALLE A",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007301816",
            "telephone_number": "787-844-4173",
            "fax_number": "787-847-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CALLE BARCELO",
            "city": "VILLALBA",
            "state": "PR",
            "postal_code": "007662230",
            "telephone_number": "787-847-4410",
            "fax_number": "787-847-2946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA AYALA",
        "first_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villalba, PR

Sources for this page

Verify at the official NPI Registry.