DR. JOSE AGUSTIN RAVELO DDS NPI 1487601613

NPI Information

NPI: 1487601613
Provider Name: DR. JOSE AGUSTIN RAVELO, DDS
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
5620 BERGENLINE AVE STE 2
WEST NEW YORK, NJ
ZIP 07093
Phone: (201) 861-9400
Get Directions

DR. Jose Agustin Ravelo, DDS is a general practice dentist in West New York, NJ. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Jose Agustin Ravelo, DDS NPI is 1487601613. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5620 BERGENLINE AVE STE 2
WEST NEW YORK, NJ
ZIP 07093-257
Phone: (201) 861-9400
Fax: (201) 861-9199

The enumeration date for this NPI number is 5/31/2006 and was last updated on 7/26/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		046379-1	NEW YORK	No
2	1223G0001X	Dentist	General Practice	DI20448	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8453501	MEDICAID	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »