Active NPI
Waldemar Jose Cordero Pacheco
- Orthodontics and Dentofacial Orthopedics Dentistry
- San German, PR
National Provider Identifier
1609744705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 3424
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 3424 | PR | MD | Orthodontics 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.