Pro Esthetic Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PRO ESTHETIC DENTAL LLC

Practice address

114 Calle de la Candelaria W Ste 107
Mayaguez, PR 00680

Phone

(787) 265-3683

NPI assigned

Nov 24, 2021

Last updated

Nov 24, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nadyan Vargas, DMDNPI 1447775457

Title

DMD

Phone

(787) 265-3683

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Pro Esthetic Dental LLC Former legal business name

Electronic endpoints 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nadyan Vargas, DMD

  • Dentist
  • San Juan, PR
  • NPI 1447775457
  NPD Authorized official
• Luis Daniel Camacho, D.D.S.

  • General Practice Dentistry
  • High Point, NC
  • NPI 1598886863
  NPD (past)

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637712000000",
    "number": "1548927569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 CALLE DE LA CANDELARIA W STE 107",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-265-3683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 CALLE DE LA CANDELARIA W STE 107",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-265-3683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO ESTHETIC DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-24",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A",
        "authorized_official_last_name": "VARGAS",
        "authorized_official_first_name": "NADYAN",
        "authorized_official_title_or_position": "DMD",
        "authorized_official_telephone_number": "787-265-3683",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8990219417",
            "state": "PR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://proestheticdentalpr.com/",
            "affiliation": "N",
            "address_1": "114 Calle De La Candelaria W Ste 107",
            "city": "Mayaguez",
            "state": "PR",
            "country_code": "US",
            "postal_code": "00680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pro Esthetic Dental LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Dentist in Mayaguez, PR
• Providers in Mayaguez, PR by specialty
• Dentist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.