Individual provider Active NPI

Liselie Reyes

  • Dentist
  • Barceloneta, PR
National Provider Identifier
1942212907
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1812 Issued in PR
Practice address
Carr. #2 KM. 55.5 Bo. Palenque
Barceloneta, PR 00617
Phone
(787) 846-0352
Fax
(787) 846-0352
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1812 PR Primary

Addresses

Primary practice location

Carr. #2 KM. 55.5 Bo. Palenque
Barceloneta, PR 00617

Mailing address

PO Box 625
Barceloneta, PR 00617-0625
Phone (787) 846-0352

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
I20160525001441 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6204125669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1812PRMDDentist

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": "1460505600000",
    "number": "1942212907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 625",
            "city": "BARCELONETA",
            "state": "PR",
            "postal_code": "006170625",
            "telephone_number": "787-846-0352",
            "fax_number": "787-846-0352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. #2 KM. 55.5 BO. PALENQUE",
            "city": "BARCELONETA",
            "state": "PR",
            "postal_code": "00617",
            "telephone_number": "787-846-0352",
            "fax_number": "787-846-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "LISELIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "1812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barceloneta, PR

Sources for this page

Verify at the official NPI Registry.