Individual provider Active NPI

Roy I Rosado Pagan, D.D.S.

  • General Practice Dentistry
  • Guanica, PR
National Provider Identifier
1962510263
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
780 Issued in PR
Practice address
42 Calle 25 de Julio
Guanica, PR 00653-2712
Phone
(787) 821-2105
Fax
(787) 821-2105
NPI assigned
Aug 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 780 PR Primary

Addresses

Primary practice location

42 Calle 25 de Julio
Guanica, PR 00653-2712

Mailing address

Calle 25 de Julio No. 42
Guanica, PR 00653-2712
Phone (787) 821-2105

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
I20160909000602 PR Order and Referring Only - DentistPractitioner - Dentist 3072809565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
780PRMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1962510263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE 25 DE JULIO NO. 42",
            "city": "GUANICA",
            "state": "PR",
            "postal_code": "006532712",
            "telephone_number": "787-821-2105",
            "fax_number": "787-821-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 CALLE 25 DE JULIO",
            "city": "GUANICA",
            "state": "PR",
            "postal_code": "006532712",
            "telephone_number": "787-821-2105",
            "fax_number": "787-821-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSADO PAGAN",
        "first_name": "ROY",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-27",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guanica, PR

Sources for this page

Verify at the official NPI Registry.