Individual provider Active NPI

Janet Diaz, DMD

  • Dentist
  • Yauco, PR
National Provider Identifier
1609869338
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2407 Issued in PR
Practice address
Carr 368 KM 12.6
Bo. Susua Baja
Yauco, PR 00698
Phone
(787) 267-1269
Fax
(787) 267-1269
NPI assigned
Aug 29, 2005
Last updated
Aug 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2407 PR Primary

Addresses

Primary practice location

Carr 368 KM 12.6
Bo. Susua Baja
Yauco, PR 00698

Mailing address

Amaury Veray a-20
Urb. Buena Vista
Yauco, PR 00698-3519
Phone (787) 267-1269

Other identifiers 3

IdentifierTypeStateIssuer
DRAJANET1OtherPRINMEDIATA
JD1269OtherINMEDIATA
SESPROOtherPRTRIPLE S

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150721001557 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3779896626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2407PRMDProfessional Counselor

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1609869338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AMAURY VERAY A-20",
            "address_2": "URB. BUENA VISTA",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006983519",
            "telephone_number": "787-267-1269",
            "fax_number": "787-267-1269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 368 KM 12.6",
            "address_2": "BO. SUSUA BAJA",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "00698",
            "telephone_number": "787-267-1269",
            "fax_number": "787-267-1269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JANET",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-29",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "2407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INMEDIATA",
            "identifier": "DRAJANET1",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INMEDIATA",
            "identifier": "JD1269",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "SESPRO",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yauco, PR

Sources for this page

Verify at the official NPI Registry.