Active NPIIndividual providerSole proprietor

Dr. Jose A Ravelo, DDS

Dentist, General Practice in West New York, New Jersey

NPI Number1487601613
Practice location
5620 Bergenline Ave Ste 2, West New York, NJ 07093-1257
Fax
201-861-9199
Last updated
July 26, 2019

Jose Agustin Ravelo is a Dentist, General Practice based in West New York, NJ. Jose Agustin Ravelo practices in West New York, NJ and has the professional credentials of DDS. The NPI Number for Jose Agustin Ravelo is 1487601613 and holds a License No. 046379-1 (NY). The current practice location address for Jose Agustin Ravelo is 5620 Bergenline Ave Ste 2, West New York, NJ 07093-1257 and can be reached out via phone at 201-861-9400 and via fax at 201-861-9199.

Provider Profile Details

NPI Number
1487601613
Provider Name
Jose Agustin Ravelo
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
5620 Bergenline Ave Ste 2, West New York, NJ 07093-1257
Phone Number
201-861-9400
Fax Number
201-861-9199
Primary Taxonomy
Dentist, General Practice · 1223G0001X
Sole Proprietor
Yes
Provider Enumeration Date
May 31, 2006
Last Update Date
July 26, 2019
NPI Status
Active

Provider Business Practice Location Address Details

Address
5620 Bergenline Ave Ste 2
West New York, NJ 07093-1257
Zip
07093-1257
Phone Number
201-861-9400
Fax Number
201-861-9199
West New York, NJ 07093Get directions →

Provider Business Mailing Address Details

Address
5620 Bergenline Ave Ste 2
West New York, NJ 07093-1257
City
West New York
State
NJ
Zip
07093-1257
Phone Number
201-861-9400
Fax Number
201-861-9199

License Information

License Number (1)
046379-1
License State (1)
NY
Taxonomy (1)
Dentist · 122300000X
License Number (2)
DI20448
License State (2)
NJ
Taxonomy (2)
Dentist, General Practice · 1223G0001X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Dr. Jose A Ravelo, DDS?

The NPI number of Dr. Jose A Ravelo, DDS is 1487601613. It was assigned on May 31, 2006 and is currently active in the NPPES registry.

What is the specialty of Dr. Jose A Ravelo, DDS?

Dr. Jose A Ravelo, DDS is registered under the primary taxonomy Dentist, General Practice (code 1223G0001X), licensed in NY under license number 046379-1.

Where does Dr. Jose A Ravelo, DDS practice?

The practice location is 5620 Bergenline Ave Ste 2, West New York, NJ 07093-1257. The office can be reached at 201-861-9400 (phone) or 201-861-9199 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1487601613 directly on the NPPES registry website.

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