Dento-Medics, CSP

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

13607 Issued in PR

Legal business name

DENTO-MEDICS, CSP

Practice address

HC 1 Box 25708
San German, PR 00683-9806

Phone

(787) 892-0585

Fax

(787) 892-0585

NPI assigned

Mar 8, 2006

Organization subpart

No

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

Authorized official

Name

Fredickson M Vargas, MDNPI 1649248758

Title

President/Secretary

Phone

(787) 892-0585

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fredickson Manuel Vargas, MD

  • Internal Medicine Physician
  • San German, PR
  • NPI 1649248758
  Medicare reassignment NPD Authorized official
• Selma Basora, DMD

  • Pediatric Dentistry
  • San German, PR
  • NPI 1205804119
  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912975723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 25708",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "006839806",
            "telephone_number": "787-892-0585",
            "fax_number": "787-892-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 25708",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "006839806",
            "telephone_number": "787-892-0585",
            "fax_number": "787-892-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTO-MEDICS, CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VARGAS",
        "authorized_official_first_name": "FREDICKSON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/SECRETARY",
        "authorized_official_telephone_number": "787-892-0585",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "13607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paola Andrea De Jesus
• Ramon De Jesus, M.D.
• De la Mano Nursing Home
• Stephanie Marie De la Matta, OD
• Dento-Lab, Inc
• Dento-Ped, CSP
• Dermatologics LLC
• Wigmar Diaz Ramos, PH D
• Yaileen M Diaz Torres, SLP
• Dominguez Medical Service

• Internal Medicine Physician in San German, PR
• Providers in San German, PR by specialty
• Internal Medicine Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.