Individual provider Active NPI

Alvin Ariel Cardona Sr., DMD

  • Dentist
  • Bayamon, PR
National Provider Identifier
1386711745
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1111 Issued in PR
Practice address
Medical Ophtalmic Plaza
Suite 202 Carr #2 KM 119
Bayamon, PR 00959
Phone
(787) 787-5147
Fax
(787) 269-7885
NPI assigned
Nov 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Dentist 122300000X 1111 PR Primary

Addresses

Primary practice location

Medical Ophtalmic Plaza
Suite 202 Carr #2 KM 119
Bayamon, PR 00959

Mailing address

Medical Ophtalmic Plaza
Suite 202 Carr #2 KM 119
Bayamon, PR 00959
Phone (787) 787-5147

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
I20170105000477 PR Order and Referring Only - DentistPractitioner - Dentist 8820379860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1111PRMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Smiles Dental Services DMD LLC General Practice PastSince Oct 1, 2021 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, 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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386711745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL OPHTALMIC PLAZA",
            "address_2": "SUITE 202 CARR #2 KM 119",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-787-5147",
            "fax_number": "787-269-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL OPHTALMIC PLAZA",
            "address_2": "SUITE 202 CARR #2 KM 119",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-787-5147",
            "fax_number": "787-269-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDONA",
        "first_name": "ALVIN",
        "middle_name": "ARIEL",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "1111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.