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1518287507 NPI number — PEDRO MARIO ALVAREZ III D.D.S

NPI Number: 1518287507
Health Care Provider/Practitioner: PEDRO MARIO ALVAREZ III D.D.S

Information about “1518287507” NPI (PEDRO MARIO ALVAREZ III D.D.S) exists in 1518287507 in HTML format HTML  |  1518287507 in plain Text format TXT  |  1518287507 in PDF (Portable Document Format) PDF  |  1518287507 in an XML format XML  formats.

NPI Number : 1518287507 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1518287507",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ALVAREZ",
    "FirstName": "PEDRO",
    "MiddleName": "MARIO",
    "NamePrefix": "DR.",
    "NameSuffix": "III",
    "Credential": "D.D.S",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "11325 SEVEN LOCKS RD STE 250",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "POTOMAC",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "20854-3269",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "240-642-3161",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "11325 SEVEN LOCKS RD STE 250",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "POTOMAC",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "20854-3269",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "240-642-3161",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/02/2010",
    "LastUpdateDate": "06/24/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "DN1855652",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "056594",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "16523",
          "LicenseNumberStateCode": "MD",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223P0221X",
          "TaxonomyName": "Pediatric Dentistry",
          "LicenseNumber": "16523",
          "LicenseNumberStateCode": "MD",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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