Individual provider Active NPI

Yessenia Rosado Gonzalez, DMD

  • General Practice Dentistry
  • Guaynabo, PR
National Provider Identifier
1831907880
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3543 Issued in PR
Practice address
HC 1 Box 6207
Guaynabo, PR 00971-9543
Phone
(787) 459-4072
NPI assigned
Dec 23, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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 3543 PR Primary

Addresses

Primary practice location

HC 1 Box 6207
Guaynabo, PR 00971-9543

Mailing address

HC 1 Box 6207
Guaynabo, PR 00971-9543
Phone (787) 459-4072

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
I20250305001665 PR Practitioner - Dentist 6507387677 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3543PRMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Estudio Dental Otero Loperena LLC General Practice CurrentSince Jan 7, 2025 Accepting new patients

Locations

120 Carr 159
Ste 203
Corozal, PR 00783

36 Carr 2
Ste 302
Vega Alta, PR 00692
Phone (787) 883-6234

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": "1734912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1831907880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 6207",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009719543",
            "telephone_number": "787-459-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 6207",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009719543",
            "telephone_number": "787-459-4072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSADO GONZALEZ",
        "first_name": "YESSENIA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-23",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "3543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.