Individual provider Active NPI

Amilcar Rafael Rodriguez Melendez, D.M.D.

  • General Practice Dentistry
  • Ponce, PR
National Provider Identifier
1770630865
Registry record updated Jan 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2668 Issued in PR
Practice address
Glenview Gardens Shopping Center
Suite #4
Ponce, PR 00731
Phone
(787) 812-3173
Fax
(787) 812-3153
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2008

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 2668 PR Primary

Addresses

Primary practice location

Glenview Gardens Shopping Center
Suite #4
Ponce, PR 00731

Mailing address

15038 Calle Ucar
Urb Paseos de Jacaranda
Santa Isabel, PR 00757
Phone (787) 608-7779

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
I20161215002239 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4385924083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Servicios Dentales DDS, LLC General Practice PastSince Oct 5, 2021 Accepting new patients
Bright Smiles Dental Services DMD LLC General Practice PastSince Mar 12, 2024 Accepting new patients

Organizations & group practices 2

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199404800000",
    "number": "1770630865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15038 CALLE UCAR",
            "address_2": "URB PASEOS DE JACARANDA",
            "city": "SANTA ISABEL",
            "state": "PR",
            "postal_code": "00757",
            "telephone_number": "787-608-7779",
            "fax_number": "787-812-3153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GLENVIEW GARDENS SHOPPING CENTER",
            "address_2": "SUITE #4",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00731",
            "telephone_number": "787-812-3173",
            "fax_number": "787-812-3153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ MELENDEZ",
        "first_name": "AMILCAR",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2008-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.