Individual provider Active NPI

Daniel Diaz Rubayo

  • General Practice Dentistry
  • San Juan, PR
National Provider Identifier
1730507450
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3194 Issued in PR
Practice address
735 Ave Ponce de Leon
Suite 713 Torre Medica Auxilio Mutuo
San Juan, PR 00917-5022
Phone
(787) 765-8394
NPI assigned
Mar 31, 2014
Last updated
Nov 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 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 3194 PR Primary

Addresses

Primary practice location

735 Ave Ponce de Leon
Suite 713 Torre Medica Auxilio Mutuo
San Juan, PR 00917-5022

Mailing address

735 Ave Ponce de Leon
Suite 713 Torre Medica Auxilio Mutuo
San Juan, PR 00917-5022
Phone (787) 765-8394

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
3194PRMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Dental Group PastSince Sep 1, 2019 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1730507450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 AVE PONCE DE LEON",
            "address_2": "SUITE 713 TORRE MEDICA AUXILIO MUTUO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175022",
            "telephone_number": "787-765-8394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 AVE PONCE DE LEON",
            "address_2": "SUITE 713 TORRE MEDICA AUXILIO MUTUO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175022",
            "telephone_number": "787-765-8394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ RUBAYO",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "3194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.