Raul A Fontane, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS2312 Issued in PR

Practice address

PR 177 Corner Santa Ana St
Centro Comercial Altomar 2ND FL
Guaynabo, PR 00969

Phone

(787) 720-9008

Fax

(787) 720-9007

NPI assigned

Sep 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578654158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 226",
            "address_2": "1353 RD 19",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009662700",
            "telephone_number": "787-720-9008",
            "fax_number": "787-720-9007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PR 177 CORNER SANTA ANA ST",
            "address_2": "CENTRO COMERCIAL ALTOMAR 2ND FL",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-720-9008",
            "fax_number": "787-720-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANE",
        "first_name": "RAUL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "DS2312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.