Individual provider Active NPI

Ovidio Arizmendi Jr., DDS

  • Dentist
  • Gurabo, PR
National Provider Identifier
1902011984
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
002170 Issued in PR
Practice address
57 Calle Santiago N
Gurabo, PR 00778-2426
Phone
(787) 737-7450
Fax
(787) 737-7450
NPI assigned
May 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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
Dentist 122300000X 002170 PR Primary

Addresses

Primary practice location

57 Calle Santiago N
Gurabo, PR 00778-2426

Mailing address

152 La Serrania
Caguas, PR 00725-1806
Phone (787) 744-8330

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
I20170330001449 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0648555805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002170PRMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902011984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 LA SERRANIA",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007251806",
            "telephone_number": "787-744-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 CALLE SANTIAGO N",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "007782426",
            "telephone_number": "787-737-7450",
            "fax_number": "787-737-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARIZMENDI",
        "first_name": "OVIDIO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "002170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurabo, PR

Sources for this page

Verify at the official NPI Registry.