Individual provider Active NPI

Luis G Renta, D.M.D.

  • General Practice Dentistry
  • Gurabo, PR
National Provider Identifier
1598793911
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1600 Issued in PR
Practice address
57 Calle Angel C Morales E
Gurabo, PR 00778-2403
Phone
(787) 737-5956
Fax
(787) 737-5956
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1600 PR Primary

Addresses

Primary practice location

57 Calle Angel C Morales E
Gurabo, PR 00778-2403

Mailing address

57 Calle Angel C Morales E
Gurabo, PR 00778-2403
Phone (787) 737-5956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1600PRMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598793911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 CALLE ANGEL C MORALES E",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "007782403",
            "telephone_number": "787-737-5956",
            "fax_number": "787-737-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 CALLE ANGEL C MORALES E",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "007782403",
            "telephone_number": "787-737-5956",
            "fax_number": "787-737-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTA",
        "first_name": "LUIS",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurabo, PR

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.