Active NPI
Olga E Reyes Marin, DMD
- Dentist
- Jayuya, PR
National Provider Identifier
1811082969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1515
- Practice address
- 10 Calle Figuera Ste 2B
Jayuya, PR 00664-1636 - Phone
- (787) 828-7716
- Fax
- (787) 828-1725
- NPI assigned
- Oct 4, 2006
- Last updated
- Mar 9, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1515 | PR | Primary |
Addresses
Primary practice location
10 Calle Figuera Ste 2B
Jayuya, PR 00664-1636
Mailing address
PO Box 1556
Jayuya, PR 00664
Phone (787) 828-7716
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220503001098 | PR | Practitioner - Dentist | 6608263025 | Practice locations: Jayuya, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1515 | PR | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646784000000",
"number": "1811082969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1556",
"city": "JAYUYA",
"state": "PR",
"postal_code": "00664",
"telephone_number": "787-828-7716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 CALLE FIGUERA STE 2B",
"city": "JAYUYA",
"state": "PR",
"postal_code": "006641636",
"telephone_number": "787-828-7716",
"fax_number": "787-828-1725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES MARIN",
"first_name": "OLGA",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2022-03-09",
"certification_date": "2022-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PR",
"license": "1515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jayuya, PR
- Jerikalys Marian Ortiz Colon
- Nelma Liz Ortiz Correa
- Jose J Perez Ramos, MD
- Primary Health Advanced Medicine LLC
- Radiologia Centro Salud Mario Canales
- Angelica Maria Reyes Rios, BSW
- Carlos Alberto Rivera Gonzalez, PHARMD
- Denisse M Rivera Gonzalez
- Nicolle Michelle Rivera- Medina
- Luis A. Rivera-Roman, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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.