Marielys Nicole Alicea Castro, DMD
Individual provider Active NPI Dentist · Vega Baja, PR
NPI 1508324880 · NPPES record last updated Oct 6, 2020
Key facts
- NPI
- 1508324880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 3349 (PR)
- Practice address
- Villas de la Playa
#174
Vega Baja, PR 00693 - Phone
- (888) 700-6623
- NPI assigned
- Mar 6, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3349 | PR | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 3349 | PR | Yes |
Addresses
Primary practice location
Villas de la Playa
#174
Vega Baja, PR 00693
Mailing address
Villas de la Playa
#174
Vega Baja, PR 00693
Other providers in Vega Baja, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.