Individual provider Active NPI

Fernando L Costas, D.M.D.

  • General Practice Dentistry
  • Carolina, PR
National Provider Identifier
1720070311
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1132 Issued in PR
Practice address
2Tr510 Via Adelina
Villa Fontana
Carolina, PR 00983-3864
Phone
(787) 762-0045
Fax
(787) 750-1460
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 1132 PR Primary

Addresses

Primary practice location

2Tr510 Via Adelina
Villa Fontana
Carolina, PR 00983-3864

Mailing address

96 Calle Gardenia
Ciudad Jardin
Carolina, PR 00987-2207
Phone (787) 762-0045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1132PRMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1720070311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 CALLE GARDENIA",
            "address_2": "CIUDAD JARDIN",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009872207",
            "telephone_number": "787-762-0045",
            "fax_number": "787-750-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2TR510 VIA ADELINA",
            "address_2": "VILLA FONTANA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009833864",
            "telephone_number": "787-762-0045",
            "fax_number": "787-750-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTAS",
        "first_name": "FERNANDO",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.