Active NPI
Gustavo Fadhel, D.M.D.
- Prosthodontics
- San Juan, PR
National Provider Identifier
1386638088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 1685
- Practice address
- San Juan City Hospital
Medical Center
San Juan, PR 00936 - Phone
- (787) 766-2223
- NPI assigned
- Sep 8, 2005
- 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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 1685 | PR | Primary |
Addresses
Primary practice location
San Juan City Hospital
Medical Center
San Juan, PR 00936
Mailing address
Luis Munoz Marin Ave. Ste 206
Quadrangle Medical Center
Caguas, PR 00725
Phone (787) 746-0895
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1223P0700X | Other | PR | TAXONOMY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1685 | PR | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oral Rehab Specialists, Inc. | 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.
-
- Dental Clinic/Center
- Caguas, PR
- NPI 1568864973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228262400000",
"number": "1386638088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "LUIS MUNOZ MARIN AVE. STE 206",
"address_2": "QUADRANGLE MEDICAL CENTER",
"city": "CAGUAS",
"state": "PR",
"postal_code": "00725",
"telephone_number": "787-746-0895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SAN JUAN CITY HOSPITAL",
"address_2": "MEDICAL CENTER",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00936",
"telephone_number": "787-766-2223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FADHEL",
"first_name": "GUSTAVO",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-08",
"last_updated": "2008-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "PR",
"license": "1685",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAXONOMY",
"identifier": "1223P0700X",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.