Individual provider Active NPI

Waldemar Jose Cordero Pacheco

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • San German, PR
National Provider Identifier
1609744705
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
3424 Issued in PR
Practice address
San German Medical Plaza
Suite #208
San German, PR 00683-9339
Phone
(787) 248-9460
NPI assigned
Oct 29, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 3424 PR Primary

Addresses

Primary practice location

San German Medical Plaza
Suite #208
San German, PR 00683-9339

Mailing address

HC 3 Box 25709
San German, PR 00683-9339
Phone (787) 248-9460

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
3424PRMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1609744705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 3 BOX 25709",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "006839339",
            "telephone_number": "787-248-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SAN GERMAN MEDICAL PLAZA",
            "address_2": "SUITE #208",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "006839339",
            "telephone_number": "787-248-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDERO PACHECO",
        "first_name": "WALDEMAR",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PR",
            "license": "3424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San German, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; 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.