Luis Manuel Bermudez, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1797 Issued in PR

Practice address

1615 Truemper St BLDG 6418
Jbsa Lackland, TX 78236-5511

Phone

(787) 787-9469

Fax

(210) 292-0676

NPI assigned

Sep 2, 2006

Last updated

Apr 13, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1902908783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 TRUEMPER ST BLDG 6418",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365511",
            "telephone_number": "210-292-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 TRUEMPER ST BLDG 6418",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365511",
            "telephone_number": "787-787-9469",
            "fax_number": "210-292-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "LUIS",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2021-04-13",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Julianne Beals, M.D.
• Lori Jun Beauchemin-Boggio
• Carl Edward Bemis, PHYSICIAN ASSISTANT
• Jessica Martinez Bennett, FNP-C
• Cassie Ann Berggren, DC
• Colleen Bernal, PA-C
• Nicole Bertram, PA
• Erika L Best, LCSW
• Allen Michael Betts, MD
• Carl Paul Bhend, D.D.S.

• General Practice Dentistry in Jbsa Lackland, TX
• Providers in Jbsa Lackland, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.