Individual provider Active NPI

Glenn L Saldana, DMD

  • Dentist
  • San Juan, PR
National Provider Identifier
1942211917
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1873 Issued in PR
Practice address
Santa Rosa Ave. #56
Suite #1
San Juan, PR 00926-5539
Phone
(787) 720-1684
Fax
(787) 708-0272
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1873 PR Primary

Addresses

Primary practice location

Santa Rosa Ave. #56
Suite #1
San Juan, PR 00926-5539

Mailing address

271 Calle Sierra Morena
MSC 271
San Juan, PR 00926-5539
Phone (787) 720-1684

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161109001374 PR Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 0042599367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1873PRMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942211917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 CALLE SIERRA MORENA",
            "address_2": "MSC 271",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265539",
            "telephone_number": "787-720-1684",
            "fax_number": "787-708-5272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SANTA ROSA AVE. #56",
            "address_2": "SUITE #1",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265539",
            "telephone_number": "787-720-1684",
            "fax_number": "787-708-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALDANA",
        "first_name": "GLENN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "1873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.