Individual provider Active NPI

Miguel Lorenzo Purcell, D.M.D

  • Dentist
  • Ponce, PR
National Provider Identifier
1679561187
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1922 Issued in PR
Practice address
8169 Calle Concordia
Cond. San Vicente Suite #4
Ponce, PR 00717-1554
Phone
(787) 840-7994
Fax
(787) 842-4067
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1922 PR Primary

Addresses

Primary practice location

8169 Calle Concordia
Cond. San Vicente Suite #4
Ponce, PR 00717-1554

Mailing address

8169 Calle Concordia
Cond. San Vicente
Ponce, PR 00717-1554
Phone (787) 840-7994

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
I20160809001712 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2961796222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1922PRMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1679561187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8169 CALLE CONCORDIA",
            "address_2": "COND. SAN VICENTE",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171554",
            "telephone_number": "787-840-7994",
            "fax_number": "787-842-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8169 CALLE CONCORDIA",
            "address_2": "COND. SAN VICENTE SUITE #4",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171554",
            "telephone_number": "787-840-7994",
            "fax_number": "787-842-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURCELL",
        "first_name": "MIGUEL",
        "middle_name": "LORENZO",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "1922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.