Javier A Ayala, DMD
Individual provider Active NPI General Practice Dentistry · Fajardo, PR
NPI 1467459586 · NPPES record last updated Jun 10, 2020
Key facts
- NPI
- 1467459586
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2563 (PR)
- Practice address
- M10 Ave Conquistador Valle Verde
Plaza del Rio Suite 201
Fajardo, PR 00738 - Phone
- (787) 860-4223
- Fax
- (787) 863-6972
- NPI assigned
- Jul 5, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200716003434 | PR | Practitioner - Dentist | 1658673413 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2563 | PR | MD | Counseling Psychologist |
| 002563 | PR | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grupo Dental Ayala del Rio CSP | General Practice | Current |
Accepting new patients |
Locations
M10 Ave El Conquistador
Fajardo, PR 00738
Phone (787) 531-6412
M10 Ave El Conquistador
Ste 201
Fajardo, PR 00738
Phone (787) 860-4223
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2563 | PR | Yes |
Addresses
Primary practice location
M10 Ave Conquistador Valle Verde
Plaza del Rio Suite 201
Fajardo, PR 00738
Mailing address
PO Box 9150
Humacao, PR 00792-9150
Phone (787) 860-4223
Other providers in Fajardo, PR
- Gladys Maria Araujo
- Ard Cardiology PSC
- Luis Armando Arraut-Ramirez
- Nashaly E Arroyo Garcia
- Atlantis Health Care Group Puerto Rico, Inc.
- B18 LLC
- Abdiel Omar Baez
- Noosha Baqi
- Baralt Medical Equipment
- Livia M. Bermudez
All providers in Fajardo, PR · General Practice Dentistry in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.