Individual provider Active NPI

Patricio Javier Sumaza, DMD

  • Endodontics
  • Mayaguez, PR
National Provider Identifier
1457356180
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
2496 Issued in PR
Practice address
351 Ave Hostos
Ste 211
Mayaguez, PR 00680-1503
Phone
(787) 986-3636
Fax
(787) 805-1610
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 2496 PR Primary

Addresses

Primary practice location

351 Ave Hostos
Ste 211
Mayaguez, PR 00680-1503

Mailing address

351 Ave Hostos
Mayaguez, PR 00680-1502
Phone (787) 986-3636

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
I20121129000556 PR Practitioner - Oral Surgery 8527210319

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1457356180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 AVE HOSTOS",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006801502",
            "telephone_number": "787-986-3636",
            "fax_number": "787-805-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 AVE HOSTOS",
            "address_2": "STE 211",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006801503",
            "telephone_number": "787-986-3636",
            "fax_number": "787-805-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMAZA",
        "first_name": "PATRICIO",
        "middle_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PR",
            "license": "2496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.