Individual provider Active NPI

Isabel M. Fuertes, DMD

  • Dentist
  • Carolina, PR
National Provider Identifier
1972595346
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1735 Issued in PR
Practice address
Castellana Gardens
Ave. Galicia # H-10
Carolina, PR 00983
Phone
(787) 752-6840
Fax
(787) 752-6840
NPI assigned
Aug 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1735 PR Primary

Addresses

Primary practice location

Castellana Gardens
Ave. Galicia # H-10
Carolina, PR 00983

Mailing address

Bosque del Lago
Plaza 8 BC-29
Trujillo Alto, PR 00976
Phone (787) 748-8969

Other identifiers 2

IdentifierTypeStateIssuer
41596OtherPRSSS
041361OtherPRCRUZ AZUL

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
I20171019001829 PR Order and Referring Only - DentistPractitioner - Dentist 1850667817

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1735PRMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1972595346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOSQUE DEL LAGO",
            "address_2": "PLAZA 8 BC-29",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "00976",
            "telephone_number": "787-748-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CASTELLANA GARDENS",
            "address_2": "AVE. GALICIA # H-10",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00983",
            "telephone_number": "787-752-6840",
            "fax_number": "787-752-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUERTES",
        "first_name": "ISABEL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "1735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "41596",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL",
            "identifier": "041361",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.