Active NPI
Juan C Ortiz de la Renta, D.D.S.
- General Practice Dentistry
- Carolina, PR
National Provider Identifier
1467553669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2374
- Practice address
- Via Mirta 3 DS-1
Villa Fontana
Carolina, PR 00983 - Phone
- (787) 776-0570
- Fax
- (787) 776-0570
- NPI assigned
- Sep 26, 2006
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2374 | PR | Primary |
Addresses
Primary practice location
Via Mirta 3 DS-1
Villa Fontana
Carolina, PR 00983
Mailing address
PO Box 8480
San Juan, PR 00910-0480
Phone (787) 776-0570
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160810000752 | PR | Order and Referring Only - Oral Surgery | 6305130634 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Puerto Rico Dental Care | General Practice | 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.
-
- General Practice Dentistry
- Carolina, PR
- NPI 1215064605
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470700800000",
"number": "1467553669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8480",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009100480",
"telephone_number": "787-776-0570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "VIA MIRTA 3 DS-1",
"address_2": "VILLA FONTANA",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00983",
"telephone_number": "787-776-0570",
"fax_number": "787-776-0570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ DE LA RENTA",
"first_name": "JUAN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2016-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PR",
"license": "2374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Carolina, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.