DR. MANUEL LUIS IRAVEDRA D.M.D., B.S.PH
NPI 1801941422
Dentist - Periodontics in Chinle, AZ

Q: What is Manuel Iravedra's NPI number?

The NPI number for Manuel Iravedra is 1801941422. It was assigned to this individual provider in the NPPES registry on January 24, 2007. The provider is also known as Manuel Luis Iravedra Gonzalez Dmd, B.S.Ph..

Q: What is Manuel Iravedra's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Q: When was this NPI record last updated?

The NPPES record for Manuel Iravedra was last updated on December 9, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 24, 2007PECOS Enrolled

PO BOX PH, CHINLE, AZ 86503(928) 674-7001 Get Directions Write a Review

NPPES record last updated: December 9, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Manuel Luis Iravedra D.m.d., B.s.ph NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MANUEL LUIS IRAVEDRA D.M.D., B.S.PH (NPI 1801941422) is an individual periodontics provider in Chinle, Arizona, licensed in Puerto Rico (D1388) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and maintains a secondary practice location in San Juan.

NPPES Registry Identity

NPI1801941422

Entity TypeIndividualMale

Primary Taxonomy1223P0300X

Provider Legal NameDR. MANUEL LUIS IRAVEDRACredential: D.M.D., B.S.PH

Location AddressPO BOX PHChinle, AZ 86503-8000

Mailing Address1814 Calle Glasgow, College ParkSan Juan, PR 00921-4814 · (787) 758-8510

Phone(928) 674-7001

Sole ProprietorYes

Enumeration DateJanuary 24, 2007

Last NPPES UpdateDecember 9, 2019

✔ NPI 1801941422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in PR · D1388

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

Also ListedPharmacistTaxonomy 183500000X · License 2750 (PR)

PO BOX PH, Chinle, AZ 86503

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Other Names 1

Other Name (5)Manuel Luis Iravedra Gonzalez Dmd, B.s.ph.

Secondary Practice Location 1

Location 11814 Calle GlasgowSan Juan, PR 00921-4814 · Phone (787) 758-8510

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Manuel Luis Iravedra D.m.d., B.s.ph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86503 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$69.24 typical visit price

range $17.72 – $137.41

Typical copayment $17.31 (range $4.43 – $34.35)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRACY A HENTZ MD

Pediatrics (Pediatric Hematology-Oncology)

PO BOX PH
CHINLE, AZ 86503

Apache County (928) 674-7001

MR. THOMAS MERRICK DAVIS R.PH.

Pharmacist

PO BOX PH
CHINLE, AZ 86503

Apache County (928) 674-7042

DR. ANDREW COOGAN PHARM,D.

Pharmacist

PO BOX PH
CHINLE, AZ 86503

Apache County (928) 674-7001

ALEXANDRIA MERRITT PHARMD

Pharmacist

PO BOX PH
CHINLE, AZ 86503

Apache County (928) 674-7502

OLUBUNMI A JAIYEOLA JR. PHARMD

Pharmacist

PO BOX PH
CHINLE, AZ 86503

Apache County (928) 674-0001

CAROLYN DIANE CLICK OD

Optometrist

PO BOX PH, HIGHWAY 191 AND HOSPITAL DRIVE
CHINLE, AZ 86503

Apache County (928) 674-7665

KATHLEEN L RUSSELL PHARMD

Pharmacist

PO BOX PH
CHINLE, AZ 86503

Apache County (928) 674-7414

DR. ETHAN REUVAN BORNSTEIN M.D.

Internal Medicine

PO BOX PH
CHINLE, AZ 86503

Apache County (928) 674-7001

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Manuel Iravedra's NPI number?

The NPI number for Manuel Iravedra is 1801941422. It was assigned to this individual provider in the NPPES registry on January 24, 2007. The provider is also known as Manuel Luis Iravedra Gonzalez Dmd, B.S.Ph..

Where is Manuel Iravedra located?

Manuel Iravedra practices at PO Box Ph, Chinle, AZ 86503. The listed phone number is (928) 674-7001.

What is Manuel Iravedra's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Manuel Iravedra enrolled in Medicare?

Yes. Manuel Iravedra is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Manuel Iravedra was last updated on December 9, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.