NPIMap

Organization Active NPI

Cavity Repair LLC

  • Dental Clinic/Center
  • Ceiba, PR
National Provider Identifier
1689043531
Registry record updated Sep 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
2080 Issued in PR
Legal business name
CAVITY REPAIR LLC
Practice address
557B Calle Julian Rivera
Ceiba, PR 00735
Phone
(787) 885-0560
Fax
(787) 885-0560
NPI assigned
Sep 22, 2015
Last updated
Sep 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2015

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

Authorized official

Name
Dr. Edwin E LafontaineNPI 1629185822
Title
President
Phone
(787) 515-7036

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 2080 PR Primary

Addresses

Primary practice location

557B Calle Julian Rivera
Ceiba, PR 00735

Mailing address

557B Julian Rivera
Ceiba, PR 00735
Phone (787) 885-0560

National Provider Directory

National Provider Directory
Tax ID family
Cavity Repair LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442880000000",
    "number": "1689043531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557B JULIAN RIVERA",
            "city": "CEIBA",
            "state": "PR",
            "postal_code": "00735",
            "telephone_number": "787-885-0560",
            "fax_number": "787-885-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557B CALLE JULIAN RIVERA",
            "city": "CEIBA",
            "state": "PR",
            "postal_code": "00735",
            "telephone_number": "787-885-0560",
            "fax_number": "787-885-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAVITY REPAIR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-22",
        "last_updated": "2015-09-22",
        "status": "A",
        "authorized_official_last_name": "LAFONTAINE",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-515-7036",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "PR",
            "license": "2080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ceiba, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; 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.