Pedro Manuel Albisu, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN 21529 Issued in FL

Practice address

8020 Dancing Wind LN
Apt 105
Naples, FL 34119-9660

Phone

(754) 246-7112

Fax

(239) 573-4867

NPI assigned

Aug 10, 2015

Last updated

Aug 10, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1760868087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8020 DANCING WIND LN",
            "address_2": "APT 105",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341199660",
            "telephone_number": "754-246-7112",
            "fax_number": "239-573-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8020 DANCING WIND LN",
            "address_2": "APT 105",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341199660",
            "telephone_number": "754-246-7112",
            "fax_number": "239-573-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBISU",
        "first_name": "PEDRO",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-10",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 21529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DN 21529",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Naples, FL
• Providers in Naples, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; 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.

Verify at the official NPI Registry.