Individual provider Active NPI

Mariel Angelie Ayala, DMD

  • General Practice Dentistry
  • Mayaguez, PR
National Provider Identifier
1992263727
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3371 Issued in PR
Practice address
101 Mendez Vigo W Ste 107
Mayaguez, PR 00680-3800
Phone
(787) 834-5680
NPI assigned
Mar 11, 2019
Last updated
Aug 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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 3371 PR Primary

Addresses

Primary practice location

101 Mendez Vigo W Ste 107
Mayaguez, PR 00680-3800

Mailing address

Bimini 1
Ponce de Leon
Mayaguez, PR 00680
Phone (787) 220-2094

Other practice location 1

Calle Felix Tio
17
Sabana Grande, PR 00637
Phone (787) 832-8835

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
I20241016004734 PR Order and Referring Only - DentistPractitioner - Dentist 2769914670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3371PRMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dentistas Asociados de Puerto Rico Single Specialty PastSince Mar 21, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1992263727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BIMINI 1",
            "address_2": "PONCE DE LEON",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-220-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MENDEZ VIGO W STE 107",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006803800",
            "telephone_number": "787-834-5680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Calle Felix Tio",
            "address_2": "17",
            "address_purpose": "LOCATION",
            "city": "Sabana Grande",
            "state": "PR",
            "postal_code": "00637",
            "country_code": "US",
            "telephone_number": "787-832-8835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYALA",
        "first_name": "MARIEL",
        "middle_name": "ANGELIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "3371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.