Individual provider Active NPI

Omar Figueroa-Valle, DDS

  • Dentist
  • Greer, SC
National Provider Identifier
1538535620
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8628 Issued in SC
Practice address
1494 W Wade Hampton Blvd
Suite D
Greer, SC 29650-1166
Phone
(864) 655-5870
Fax
(864) 655-5874
NPI assigned
Aug 12, 2015
Last updated
Aug 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8628 SC Primary

Addresses

Primary practice location

1494 W Wade Hampton Blvd
Suite D
Greer, SC 29650-1166

Mailing address

1494 W Wade Hampton Blvd
Suite D
Greer, SC 29650-1166
Phone (864) 655-5870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20160503000359 SC Order and Referring Only - DentistPractitioner - Dentist 9739488362

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": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1538535620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1494 W WADE HAMPTON BLVD",
            "address_2": "SUITE D",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296501166",
            "telephone_number": "864-655-5870",
            "fax_number": "864-655-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1494 W WADE HAMPTON BLVD",
            "address_2": "SUITE D",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296501166",
            "telephone_number": "864-655-5870",
            "fax_number": "864-655-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIGUEROA-VALLE",
        "first_name": "OMAR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "8628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.