Individual provider Active NPI

Mario Falletti, DMD

  • General Practice Dentistry
  • San German, PR
National Provider Identifier
1659465144
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
PR2369 Issued in PR
Practice address
#62 Dr Veve
San German, PR 00683
Phone
(787) 892-3672
Fax
(787) 892-6909
NPI assigned
Oct 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PR2369 PR Primary

Addresses

Primary practice location

#62 Dr Veve
San German, PR 00683

Mailing address

PO Box 124
San German, PR 00683-0124
Phone (787) 892-3672

Other identifiers 7

IdentifierTypeStateIssuer
2369OtherPRLICENCIA DENTAL
041980OtherPRCRUZ AZUL
1192OtherPRIMC
206286OtherPRPREFERED HEALTH
6230072OtherPRHUMANA
42352OtherPRSSS
70141OtherPRPREFERED MEDICARE CHOICE

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
I20150629002420 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1557673845

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR2369PRMDGeneral Practice Dentistry
2369PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659465144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 124",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "006830124",
            "telephone_number": "787-892-3672",
            "fax_number": "787-892-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#62 DR VEVE",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "00683",
            "telephone_number": "787-892-3672",
            "fax_number": "787-892-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLETTI",
        "first_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "PR2369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCIA DENTAL",
            "identifier": "2369",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL",
            "identifier": "041980",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IMC",
            "identifier": "1192",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERED HEALTH",
            "identifier": "206286",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "6230072",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "42352",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERED MEDICARE CHOICE",
            "identifier": "70141",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San German, PR

Sources for this page

Verify at the official NPI Registry.