Active NPI
Marielys Nicole Alicea Castro, DMD
- Dentist
- Vega Baja, PR
National Provider Identifier
1508324880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3349
- Practice address
- Villas de la Playa
#174
Vega Baja, PR 00693 - Phone
- (888) 700-6623
- NPI assigned
- Mar 6, 2019
- Last updated
- Oct 6, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3349 | PR | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
Villas de la Playa
#174
Vega Baja, PR 00693
Mailing address
Villas de la Playa
#174
Vega Baja, PR 00693
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3349 | PR | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601942400000",
"number": "1508324880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "VILLAS DE LA PLAYA",
"address_2": "#174",
"city": "VEGA BAJA",
"state": "PR",
"postal_code": "00693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "VILLAS DE LA PLAYA",
"address_2": "#174",
"city": "VEGA BAJA",
"state": "PR",
"postal_code": "00693",
"telephone_number": "888-700-6623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALICEA CASTRO",
"first_name": "MARIELYS",
"middle_name": "NICOLE",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-06",
"last_updated": "2020-10-06",
"certification_date": "2020-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PR",
"license": "3349",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vega Baja, PR
- Luisito Aguilar Abreu, PSY D.
- Edgardo Javier Alegria, MS, DMD
- Aleida L. Rodriguez Inc. (Farmacia la Asturiana)
- Aleida L. Rodriguez Mirand & Farmaci (Farmacia Nater)
- Alianza Nueva Transport Inc.
- Yarah Enid Alicea, PT
- Zuleika Marie Alicea, SLP
- Alpes Advanced Logistic Psychological Educational Services
- Alpha Therapy Group
- Yadira Alvarado, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; 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.