Individual provider Active NPI

Angel Manuel Rodriguez

  • General Practice Dentistry
  • Toa Baja, PR
National Provider Identifier
1780789933
Registry record updated Jul 8, 2007
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1757 Issued in PR
Practice address
1171 Ave Dos Palmas
Levittown
Toa Baja, PR 00949-4102
Phone
(787) 795-1546
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1757 PR Primary

Addresses

Primary practice location

1171 Ave Dos Palmas
Levittown
Toa Baja, PR 00949-4102

Mailing address

1171 Ave Dos Palmas
Levittown
Toa Baja, PR 00949-4102
Phone (787) 795-1546

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
I20240329002656 PR Practitioner - Dentist 1254779036 Practice locations: Toa Baja, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780789933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 AVE DOS PALMAS",
            "address_2": "LEVITTOWN",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009494102",
            "telephone_number": "787-795-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 AVE DOS PALMAS",
            "address_2": "LEVITTOWN",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009494102",
            "telephone_number": "787-795-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ANGEL",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Baja, PR

Sources for this page

Verify at the official NPI Registry.