Individual provider Active NPI

Milton Luis Matos Roman, D.M.D.

  • Dentist
  • Bayamon, PR
National Provider Identifier
1780840181
Registry record updated Aug 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2804 Issued in PR
Practice address
192 Betances Avenue
Hnas Davila
Bayamon, PR 00959
Phone
(787) 787-8555
NPI assigned
Aug 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2804 PR Primary

Addresses

Primary practice location

192 Betances Avenue
Hnas Davila
Bayamon, PR 00959

Mailing address

192 Betances Avenue
Hnas Davila
Bayamon, PR 00959

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
2804PRMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218326400000",
    "number": "1780840181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 BETANCES AVENUE",
            "address_2": "HNAS DAVILA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 BETANCES AVENUE",
            "address_2": "HNAS DAVILA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-787-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS ROMAN",
        "first_name": "MILTON",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-05",
        "last_updated": "2008-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "2804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2008; 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.