Individual provider Active NPI

Maria M Bermudez, DMD

  • Dentist
  • Carolina, PR
National Provider Identifier
1376756841
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2391 Issued in PR
Practice address
Calle 401 Blo 143 #6
Villa Carolina
Carolina, PR 00985
Phone
(787) 768-0485
Fax
(787) 776-5461
NPI assigned
May 8, 2007
Last updated
Mar 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2391 PR Primary

Addresses

Primary practice location

Calle 401 Blo 143 #6
Villa Carolina
Carolina, PR 00985

Mailing address

PO Box 1953
Canovanas, PR 00729-1953
Phone (787) 768-0485

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
I20260622002827 PR Practitioner - Dentist 9335552678 Practice locations: Carolina, PR

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
University of Puerto Rico School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

143 -6 Calle
Suite 401
Carolina, PR 00985

143 -6 Calle
Suite 401
Carolina, PR 00985-4022
Phone (787) 768-0485

Gianna Laura Apartments
Edif 2 Apt 806
Ponce, PR 00716-3714

Plaza Iturregui Mall
1135 65 Inf Suite 203B
San Juan, PR 00924-3402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1376756841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1953",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "007291953",
            "telephone_number": "787-768-0485",
            "fax_number": "787-776-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE 401 BLO 143 #6",
            "address_2": "VILLA CAROLINA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00985",
            "telephone_number": "787-768-0485",
            "fax_number": "787-776-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "MARIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "2391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.