Individual provider Active NPI

David Emilio Kerr, DMD

  • General Practice Dentistry
  • Humacao, PR
National Provider Identifier
1639131808
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1397 Issued in PR
Practice address
350 Calle Font Martelo
Humacao, PR 00791-3266
Phone
(787) 852-8600
Fax
(787) 852-7930
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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 1397 PR Primary

Addresses

Primary practice location

350 Calle Font Martelo
Humacao, PR 00791-3266

Mailing address

350 Calle Font Martelo
Humacao, PR 00791-3266
Phone (787) 852-8600

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
I20150811004138 PR Order and Referring Only - DentistPractitioner - Oral SurgeryPractitioner - Dentist 0446565113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1397PRMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1639131808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 CALLE FONT MARTELO",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007913266",
            "telephone_number": "787-852-8600",
            "fax_number": "787-852-7930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 CALLE FONT MARTELO",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007913266",
            "telephone_number": "787-852-8600",
            "fax_number": "787-852-7930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "DAVID",
        "middle_name": "EMILIO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.