Individual provider Active NPI

Walter Vivaldi, D.M.D

  • General Practice Dentistry
  • Anasco, PR
National Provider Identifier
1811088966
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2154 Issued in PR
Practice address
32 Calle Victoria
Anasco, PR 00610-2933
Phone
(787) 826-7001
Fax
(787) 826-7001
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

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 2154 PR Primary

Addresses

Primary practice location

32 Calle Victoria
Anasco, PR 00610-2933

Mailing address

32 Calle Victoria
Anasco, PR 00610-2933
Phone (787) 826-7001

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
2154PRMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Vqa Dental Services PSC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811088966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 CALLE VICTORIA",
            "city": "ANASCO",
            "state": "PR",
            "postal_code": "006102933",
            "telephone_number": "787-826-7001",
            "fax_number": "787-826-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 CALLE VICTORIA",
            "city": "ANASCO",
            "state": "PR",
            "postal_code": "006102933",
            "telephone_number": "787-826-7001",
            "fax_number": "787-826-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVALDI",
        "first_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anasco, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.