Wanda Nazario, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2123 Issued in PR

Practice address

100 Grand Paseos Blvd Suite 112
PMB 150
San Juan, PR 00926

Phone

(787) 766-4979

NPI assigned

Nov 13, 2006

Last updated

Oct 30, 2015By the provider in NPPES

Sex

Female

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: wanda.nazario@hpmpr.eclinicaldirectplus.com

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1932270667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GRAND PASEOS BLVD",
            "address_2": "PMB 150 SUITE 112",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-688-6361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GRAND PASEOS BLVD SUITE 112",
            "address_2": "PMB 150",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-766-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZARIO",
        "first_name": "WANDA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edna Nazario-Velasco, PH.D.
• Janira Nazario, MD
• Juan Angel Nazario, M.D.
• Luis E Nazario
• Sylvette Nazario, M.D.
• NBC Gastroenterology LLC
• NBR Physiatry PSC
• NCD Endocrinology LLC
• Liliany Marie Neaves Betances
• Gisela Negrin Garcia, MD

• General Practice Dentistry in San Juan, PR
• Providers in San Juan, PR by specialty
• General Practice Dentistry in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.

Verify at the official NPI Registry.