Individual provider Active NPI

Juan Carlos Marcano Ceballos, D.D.S

  • Dentist
  • West Palm Beach, FL
National Provider Identifier
1043411796
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN26540 Issued in FL
Practice address
901 Village Blvd Ste 700
West Palm Beach, FL 33409-1947
Phone
(561) 328-6360
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30026674 OH
Dentist 122300000X DN26540 FL Primary

Addresses

Primary practice location

901 Village Blvd Ste 700
West Palm Beach, FL 33409-1947

Mailing address

901 Village Blvd Ste 700
West Palm Beach, FL 33409-1947
Phone (561) 328-6360

Other practice location 1

2263 S University Dr
Davie, FL 33324-5825
Phone (954) 475-0700

Other practice location 2

1945 N Pine Island Rd
Sunrise, FL 33322-5203
Phone (954) 473-9161

Other practice location 3

3676 Collin Dr Ste 4
West Palm Beach, FL 33406-4718
Phone (561) 965-0292

Other practice location 4

4267 W Commercial Blvd
Tamarac, FL 33319-3305
Phone (954) 677-3202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180807001221 MI Order and Referring Only - DentistPractitioner - Dentist 9032467154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN26540FLMDDentist
30026674OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Dental Care PA Dentist Past Accepting new patients
Alpha Dental Akron Ming Yu DDS LLC Dentist PastSince Feb 1, 2022 Accepting new patients
Allure Dental PLLC Dentist Past Accepting new patients
Allure Dental of Plantation PLLC PastSince Sep 1, 2023 Accepting new patients
Allure Dental WPB PLLC PastSince Jul 16, 2023 Accepting new patients
Maria M. Egusquiza DMD PA Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1043411796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 VILLAGE BLVD STE 700",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334091947",
            "telephone_number": "561-328-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 VILLAGE BLVD STE 700",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334091947",
            "telephone_number": "561-328-6360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2263 S University Dr",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333245825",
            "country_code": "US",
            "telephone_number": "954-475-0700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1945 N Pine Island Rd",
            "address_purpose": "LOCATION",
            "city": "Sunrise",
            "state": "FL",
            "postal_code": "333225203",
            "country_code": "US",
            "telephone_number": "954-473-9161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3676 Collin Dr Ste 4",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334064718",
            "country_code": "US",
            "telephone_number": "561-965-0292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4267 W Commercial Blvd",
            "address_purpose": "LOCATION",
            "city": "Tamarac",
            "state": "FL",
            "postal_code": "333193305",
            "country_code": "US",
            "telephone_number": "954-677-3202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCANO CEBALLOS",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30026674",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN26540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.