Edwin S. Lugo-Matias, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2475 Issued in PR

Practice address

PR 149, KM 62.4
Guayabal Professional BLDG., Suite 2002
Juana Diaz, PR 00795-9519

Phone

(787) 837-8346

Fax

(787) 580-7184

NPI assigned

Sep 22, 2005

Last updated

Dec 14, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734134400000",
    "number": "1487640793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CALLE PALMA REAL",
            "address_2": "URB. CAMINO REAL",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "007959302",
            "telephone_number": "787-837-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PR 149, KM 62.4",
            "address_2": "GUAYABAL PROFESSIONAL BLDG., SUITE 2002",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "007959519",
            "telephone_number": "787-837-8346",
            "fax_number": "787-580-7184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUGO-MATIAS",
        "first_name": "EDWIN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2024-12-14",
        "certification_date": "2024-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lennys Lopez Alicea
• Yiselle Lopez Ortiz, M.D.
• Rosali Lopez Perez, CPHT
• Brenda I. Lopez, M.D.
• Christian Lopez
• Julio Lugo, RPH.
• Luis G Santiago Balbes
• Juan C Machado Torres, MD
• Jose A Maiz, BS MT
• Anthony Maldonado Arroyo

• General Practice Dentistry in Juana Diaz, PR
• Providers in Juana Diaz, PR by specialty
• General Practice Dentistry in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2024; 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.

Verify at the official NPI Registry.