Individual provider Active NPI

Ingrid M Rosso-Tridas, DMD

  • General Practice Dentistry
  • Juana Diaz, PR
National Provider Identifier
1710984836
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1646 Issued in PR
Practice address
54 Calle Munoz Rivera
Juana Diaz, PR 00795-1608
Phone
(787) 837-4544
Fax
(787) 837-3851
NPI assigned
Jul 5, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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 1646 PR Primary

Addresses

Primary practice location

54 Calle Munoz Rivera
Juana Diaz, PR 00795-1608

Mailing address

54 Calle Munoz Rivera
Juana Diaz, PR 00795-1681
Phone (787) 837-4544

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
I20150706001142 PR Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 4082926092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Instituto Dental del Sur.C.S.P. General Practice PastSince Jan 19, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1710984836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 CALLE MUNOZ RIVERA",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "007951681",
            "telephone_number": "787-837-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 CALLE MUNOZ RIVERA",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "007951608",
            "telephone_number": "787-837-4544",
            "fax_number": "787-837-3851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSO-TRIDAS",
        "first_name": "INGRID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juana Diaz, PR

Sources for this page

Verify at the official NPI Registry.