Patricia Jaquez, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN17593 Issued in FL

Practice address

12297 Pembroke Rd
Pembroke Pines, FL 33025-1725

Phone

(954) 430-0308

Fax

(954) 438-5774

NPI assigned

Aug 17, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Patricia M. Jaquez, DMD PA

  • General Practice Dentistry
  • Pembroke Pines, FL
  • NPI 1063879559
  NPD (past) Authorized official
• Flamingo Dental Associates

  • General Practice Dentistry
  • Pembroke Pines, FL
  • NPI 1245417088
  NPD (past)

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250467200000",
    "number": "1013149517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12297 PEMBROKE RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330251725",
            "telephone_number": "954-430-0308",
            "fax_number": "954-438-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12297 PEMBROKE RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330251725",
            "telephone_number": "954-430-0308",
            "fax_number": "954-438-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAQUEZ",
        "first_name": "PATRICIA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-17",
        "last_updated": "2009-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hillary M Jaramillo Da Costa
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• General Practice Dentistry in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.