Individual provider Active NPI

Luz Ines Rivera Perez, DMD

  • General Practice Dentistry
  • Bayamon, PR
National Provider Identifier
1710188925
Registry record updated Jan 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2378 Issued in PR
Practice address
19-5 Calle 28
Urb. Miraflores
Bayamon, PR 00957-3736
Phone
(787) 509-5711
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2015

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 2378 PR Primary

Addresses

Primary practice location

19-5 Calle 28
Urb. Miraflores
Bayamon, PR 00957-3736

Mailing address

19-5 Calle 28
Urb. Miraflores
Bayamon, PR 00957-3736
Phone (787) 509-5711

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
I20160920000114 PR Order and Referring Only - DentistPractitioner - Dentist 9032406053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2378PRMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422316800000",
    "number": "1710188925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19-5 CALLE 28",
            "address_2": "URB. MIRAFLORES",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009573736",
            "telephone_number": "787-509-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19-5 CALLE 28",
            "address_2": "URB. MIRAFLORES",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009573736",
            "telephone_number": "787-509-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA PEREZ",
        "first_name": "LUZ INES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2015-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.