Individual provider Active NPI

Nadyan Vargas, DMD

  • Dentist
  • San Juan, PR
National Provider Identifier
1447775457
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3237 Issued in PR
Practice address
University District Hospital, PR Medical Center
Bo. Monacillos
San Juan, PR 00936
Phone
(787) 758-2525
NPI assigned
Aug 10, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3237 PR Primary

Addresses

Primary practice location

University District Hospital, PR Medical Center
Bo. Monacillos
San Juan, PR 00936

Mailing address

191 Calle Cesar Gonzalez Apt 804
San Juan, PR 00918-1429
Phone (787) 600-5385

Other identifiers 1

IdentifierTypeStateIssuer
3237MedicaidPR

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

LicenseStateTypeSpecialty
3237PRMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Esthetic Dental LLC Dentist CurrentSince Nov 28, 2021 Accepting new patients
Dr. Luis Daniel Camacho C.S.P. Dentist Past Accepting new patients

Locations

114 Calle de la Candelaria W
Ste 107
Mayaguez, PR 00680
Phone (787) 265-3683

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1447775457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 CALLE CESAR GONZALEZ APT 804",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009181429",
            "telephone_number": "787-600-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY DISTRICT HOSPITAL, PR MEDICAL CENTER",
            "address_2": "BO. MONACILLOS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00936",
            "telephone_number": "787-758-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "NADYAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "3237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3237",
            "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 Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.