Individual provider Active NPI

Rene J Aviles, DMD

  • General Practice Dentistry
  • Palm City, FL
National Provider Identifier
1619081114
Registry record updated Sep 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN14524 Issued in FL
Practice address
870 SW Martin Downs Blvd Ste 1
Palm City, FL 34990-2855
Phone
(772) 283-6881
Fax
(772) 283-6362
NPI assigned
Aug 19, 2006
Last updated
Sep 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2011

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 DN14524 FL Primary

Addresses

Primary practice location

870 SW Martin Downs Blvd Ste 1
Palm City, FL 34990-2855

Mailing address

870 SW Martin Downs Blvd Ste 1
Palm City, FL 34990-2855
Phone (772) 283-6881

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
DN14524FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1619081114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 SW MARTIN DOWNS BLVD STE 1",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349902855",
            "telephone_number": "772-283-6881",
            "fax_number": "772-283-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 SW MARTIN DOWNS BLVD STE 1",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349902855",
            "telephone_number": "772-283-6881",
            "fax_number": "772-283-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILES",
        "first_name": "RENE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; 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.