Active NPI
Carlos Clavell, DDS
- General Practice Dentistry
- Anasco, PR
National Provider Identifier
1609874825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1183
- Practice address
- 67 Calle 65 Infanteria
Anasco, PR 00610-2909 - Phone
- (787) 826-1178
- NPI assigned
- Jul 12, 2005
- Last updated
- Dec 4, 2012
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1183 | PR | Primary |
Addresses
Primary practice location
67 Calle 65 Infanteria
Anasco, PR 00610-2909
Mailing address
PO Box 6424
Mayaguez, PR 00681-6424
Phone (787) 826-1178
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161018002118 | PR | Order and Referring Only - Other (Physician) | 2466740840 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1183 | PR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354579200000",
"number": "1609874825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6424",
"city": "MAYAGUEZ",
"state": "PR",
"postal_code": "006816424",
"telephone_number": "787-826-1178",
"fax_number": "787-826-5260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 CALLE 65 INFANTERIA",
"city": "ANASCO",
"state": "PR",
"postal_code": "006102909",
"telephone_number": "787-826-1178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAVELL",
"first_name": "CARLOS",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-12",
"last_updated": "2012-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PR",
"license": "1183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anasco, PR
- Champi Medical and Wellness Group
- Champi Medical and Wellness Group Corp
- Champi Physician Services LLC
- Joann Chaparro, M.T.
- Jemerlyn Marie Charneco
- Clinica de Salud Y Prevencion de Anasco
- Clinica de Salud Y Prevencion de Anasco Inc
- Clinica Top LLC
- Clinica Yaguez Inc (Centro Radiologico Pavia Health Clinic Anasco)
- Clinica Yaguez Inc (Laboratorio Pavia Health Clinic Anasco)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.