Active NPI
Jose R Diaz, DDS
- Dentist
- Humacao, PR
National Provider Identifier
1902808900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1890
- Practice address
- Calle Antonio Lopez #67
Humacao, PR 00791 - Phone
- (787) 850-5060
- Fax
- (787) 850-1305
- NPI assigned
- Aug 10, 2005
- Sex
- Male
- 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 | 1890 | PR | Primary |
Addresses
Primary practice location
Calle Antonio Lopez #67
Humacao, PR 00791
Mailing address
PO Box 890
PMB 424
Humacao, PR 00792-0890
Phone (787) 850-5060
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 |
|---|---|---|---|---|
| I20160525002723 | PR | Order and Referring Only - Oral Surgery | 1254621642 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1890 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361923200000",
"number": "1902808900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 890",
"address_2": "PMB 424",
"city": "HUMACAO",
"state": "PR",
"postal_code": "007920890",
"telephone_number": "787-850-5060",
"fax_number": "787-850-1305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CALLE ANTONIO LOPEZ #67",
"city": "HUMACAO",
"state": "PR",
"postal_code": "00791",
"telephone_number": "787-850-5060",
"fax_number": "787-850-1305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "JOSE",
"middle_name": "R",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-10",
"last_updated": "2013-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PR",
"license": "1890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Humacao, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.