Individual provider Active NPI

Mayra Leticia Llado Ortega, D.M.D

  • Prosthodontics
  • San Juan, PR
National Provider Identifier
1508991076
Registry record updated Dec 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
2148 Issued in PR
Practice address
374 Calle Rafael Lamar
Ext Roosevelt
San Juan, PR 00918-2117
Phone
(787) 767-7471
Fax
(787) 765-9643
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 2148 PR Primary

Addresses

Primary practice location

374 Calle Rafael Lamar
Ext Roosevelt
San Juan, PR 00918-2117

Mailing address

Calle Rafael Lamar 374-a
Ext Roosevelt
Hato Rey, PR 00918
Phone (787) 767-7471

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230804003395 PR Practitioner - Dentist 5193023596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2148PRMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355961600000",
    "number": "1508991076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE RAFAEL LAMAR 374-A",
            "address_2": "EXT ROOSEVELT",
            "city": "HATO REY",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-767-7471",
            "fax_number": "787-765-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 CALLE RAFAEL LAMAR",
            "address_2": "EXT ROOSEVELT",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009182117",
            "telephone_number": "787-767-7471",
            "fax_number": "787-765-9643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLADO ORTEGA",
        "first_name": "MAYRA",
        "middle_name": "LETICIA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2012-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "PR",
            "license": "2148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.