Active NPI
Leopoldo R Luna, DDS
- General Practice Dentistry
- Rio Grande, PR
National Provider Identifier
1720097629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1062
- Practice address
- 9 Calle Dolores
Rio Grande, PR 00745-3054 - Phone
- (787) 887-4746
- Fax
- (787) 887-4746
- NPI assigned
- Aug 7, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1062 | PR | Primary |
Addresses
Primary practice location
9 Calle Dolores
Rio Grande, PR 00745-3054
Mailing address
PO Box 1149
Rio Grande, PR 00745-1149
Phone (787) 887-4746
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 046185 | Other | PR | PR STATE DRUG LICENCE |
| 9164358 | Other | PR | FEDERAL DRUG LICENCE |
| 40998 | Other | PR | SSS HEALTH PLAN |
| 1062 | Other | PR | STATE LICENCE |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160321000268 | PR | Order and Referring Only - Oral Surgery | 1153628045 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1062 | PR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720097629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1149",
"city": "RIO GRANDE",
"state": "PR",
"postal_code": "007451149",
"telephone_number": "787-887-4746",
"fax_number": "787-887-4746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 CALLE DOLORES",
"city": "RIO GRANDE",
"state": "PR",
"postal_code": "007453054",
"telephone_number": "787-887-4746",
"fax_number": "787-887-4746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNA",
"first_name": "LEOPOLDO",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PR",
"license": "1062",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PR STATE DRUG LICENCE",
"identifier": "046185",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL DRUG LICENCE",
"identifier": "9164358",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SSS HEALTH PLAN",
"identifier": "40998",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENCE",
"identifier": "1062",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rio Grande, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.