Cavity Repair LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

2080 Issued in PR

Legal business name

CAVITY REPAIR LLC

Practice address

Palmas Plantation
122
Humacao, PR 00791-6022

Phone

(787) 515-7036

Fax

(787) 885-0560

NPI assigned

Jan 26, 2016

Last updated

Jan 26, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

CAVITY REPAIR LLCAs reported in NPPES

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

Authorized official

Name

Mr. Edwin E Lafontaine, DMDNPI 1629185822

Title

Dentist

Phone

(787) 515-7036

Specialties & licenses 1

Addresses

Tax ID family

Cavity Repair LLC2 organizations share this tax ID, including this one

Part of

Cavity Repair LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Cavity Repair LLC

  • Dental Clinic/Center
  • Ceiba, PR
  • NPI 1689043531
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Cavity Repair LLC

  • Dental Clinic/Center
  • Ceiba, PR
  • NPI 1689043531
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edwin E Lafontaine, DMD

  • General Practice Dentistry
  • Ceiba, PR
  • NPI 1629185822
  NPD (past) Authorized official

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1487011128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 PALMAS PLANTATION",
            "address_2": "TEE STREET",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007916022",
            "telephone_number": "787-515-7136",
            "fax_number": "787-885-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PALMAS PLANTATION",
            "address_2": "122",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007916022",
            "telephone_number": "787-515-7036",
            "fax_number": "787-885-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAVITY REPAIR LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAVITY REPAIR LLC",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "LAFONTAINE",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "787-515-7036",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "PR",
            "license": "2080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlos Eugenio Carrion, M.D.
• Paola Casanova
• Victor Castillo, MD
• Fabiola M Castro Vazquez
• Lesliane Enid Castro-Santana, M.D.
• Cenit Medical Consultants LLC
• Centro Avanzado Patologia Y Terapia del Habla Inc.
• Centro Clinico Vega Roman PSC
• Centro de Aprendizaje Multisensorial Integrado Corp
• Centro de Desarrollo Para la Ninez

• Dental Clinic/Center in Humacao, PR
• Providers in Humacao, PR by specialty
• Dental Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.