Jorge A Roman Sr., DMD
Individual provider Active NPI General Practice Dentistry · Quebradillas, PR
NPI 1922026459 · NPPES record last updated Jun 1, 2015
Key facts
- NPI
- 1922026459
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 1493 (PR)
- Practice address
- Carr.#2 KM 96.8 Bo. Cocos
Altos Farmacia Gloriana
Quebradillas, PR 00678 - Phone
- (787) 895-4781
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160208000431 | PR | Order and Referring Only - Dentist |
0840594156 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1493 | PR | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ar Dental Clinic LLC | General Practice | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1493 | PR | Yes |
Addresses
Primary practice location
Carr.#2 KM 96.8 Bo. Cocos
Altos Farmacia Gloriana
Quebradillas, PR 00678
Mailing address
PO Box 1878
Rincon, PR 00677-1878
Phone (787) 593-0221
Other providers in Quebradillas, PR
- Clelia Rolon
- Alba Ismari Roman Arroyo
- Nelmarie Roman Diaz
- Aracelys Roman
- Aurea Esther Roman
- Maria Elena Roman
- Awilda Rosa-Morales
- Patricia Lorein Rosado Roman
- Paola Viviana Rosado
- Maribel Rosario Lopez
All providers in Quebradillas, PR · General Practice Dentistry in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.