Individual provider Active NPI

Cesar Bravo Garcia, DMD

  • General Practice Dentistry
  • San Juan, PR
National Provider Identifier
1891880340
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D1929 Issued in PR
Practice address
1057 William Jones St.
San Juan, PR 00928-1057
Phone
(787) 764-8696
Fax
(787) 756-8427
NPI assigned
Oct 3, 2006
Last updated
Nov 10, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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 D1929 PR Primary

Addresses

Primary practice location

1057 William Jones St.
San Juan, PR 00928-1057

Mailing address

PO Box 20651
San Juan, PR 00928-0651
Phone (787) 764-8696

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
I20161130000603 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7315227899

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1929PRMDPsychologist
D1929PRMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Dental Bravo II LLC General Practice Past Accepting new patients
Clinica Dental Bravo General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1891880340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20651",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009280651",
            "telephone_number": "787-764-8696",
            "fax_number": "787-756-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 WILLIAM JONES ST.",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009281057",
            "telephone_number": "787-764-8696",
            "fax_number": "787-756-8427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO GARCIA",
        "first_name": "CESAR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "D1929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.