Active NPI
Teodoro Lopez Rivera, D.M.D., MSCD.
- Pediatric Dentistry
- Ponce, PR
National Provider Identifier
1487650164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 728
- Practice address
- Edificio Clausells 129 Calle Villa
Suite 24
Ponce, PR 00730 - Phone
- (787) 844-1880
- Fax
- (787) 844-5885
- NPI assigned
- Jun 27, 2005
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 728 | PR | Primary |
Addresses
Primary practice location
Edificio Clausells 129 Calle Villa
Suite 24
Ponce, PR 00730
Mailing address
PO Box 330707
Ponce, PR 00733-0707
Phone (787) 844-1880
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040471 | Other | PR | CRUZ AZUL |
| 237025 | Other | PR | UTI |
| 4722 | Other | PR | INTERNATIONAL MEDICAL CAR |
| 40719 | Other | PR | SEGUROS SERVICIOS SALUD |
| 7310173 | Other | PR | HUMANA |
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 |
|---|---|---|---|---|
| I20161228000510 | PR | Order and Referring Only - Dentist | 2668770264 |
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": "1119830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466985600000",
"number": "1487650164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 330707",
"city": "PONCE",
"state": "PR",
"postal_code": "007330707",
"telephone_number": "787-844-1880",
"fax_number": "787-844-5885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "EDIFICIO CLAUSELLS 129 CALLE VILLA",
"address_2": "SUITE 24",
"city": "PONCE",
"state": "PR",
"postal_code": "00730",
"telephone_number": "787-844-1880",
"fax_number": "787-844-5885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ RIVERA",
"first_name": "TEODORO",
"name_prefix": "Dr.",
"credential": "D.M.D., MSCD.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-27",
"last_updated": "2016-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "PR",
"license": "728",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRUZ AZUL",
"identifier": "040471",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UTI",
"identifier": "237025",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERNATIONAL MEDICAL CAR",
"identifier": "4722",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SEGUROS SERVICIOS SALUD",
"identifier": "40719",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "7310173",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ponce, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.