Individual provider Active NPI

Lidia M Guerrero-Rodriguez, DMD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • San Juan, PR
National Provider Identifier
1497744072
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
2074 Issued in PR
Practice address
181 South Marginal Street
Corner of 521 Valcarcel Street
San Juan, PR 00923-3337
Phone
(787) 755-4347
Fax
(787) 520-7288
NPI assigned
Oct 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2074 PR
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 2074 PR Primary

Addresses

Primary practice location

181 South Marginal Street
Corner of 521 Valcarcel Street
San Juan, PR 00923-3337

Mailing address

PO Box 29736
San Juan, PR 00929-0736
Phone (787) 755-4347

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140908000772 PR Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 6507084498 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
University of Puerto Rico School of Dentistry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Cirugia Oral Y Maxilofacial
Urb Reparto America 521 Calle Antonio Valca
San Juan, PR 00923-3337
Phone (787) 755-4347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2074PRMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Recinto de Ciencias Medicas Oral & Maxillofacial Surgery CurrentSince Jul 28, 2014 Accepting new patients
Recinto de Ciencias Medicas CurrentSince Jul 28, 2014 Accepting new patients
Soc Dres Atilano Leon, Jose a Morales, Edgar Echevarria Past Accepting new patients
Departamento de Salud Oficial Past Accepting new patients

Locations

Primer Piso Hospital De Tr
San Juan, PR 00935

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1497744072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29736",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009290736",
            "telephone_number": "787-755-4347",
            "fax_number": "787-283-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 SOUTH MARGINAL STREET",
            "address_2": "CORNER OF 521 VALCARCEL STREET",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009233337",
            "telephone_number": "787-755-4347",
            "fax_number": "787-520-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO-RODRIGUEZ",
        "first_name": "LIDIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-17",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "2074",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "PR",
            "license": "2074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.