Active NPI
San Juan Dental Center LLC
- Pediatric Dentistry
- San Juan, PR
National Provider Identifier
1083198576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- Legal business name
- SAN JUAN DENTAL CENTER LLC
- Practice address
- 456 Calle Cesar Gonzalez
San Juan, PR 00918-2628 - Phone
- (787) 645-0089
- NPI assigned
- Sep 20, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rosa Maria Rodriguez, DMD
- Title
- Doctor
- Phone
- (787) 645-0089
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | Primary |
Addresses
Primary practice location
456 Calle Cesar Gonzalez
San Juan, PR 00918-2628
Mailing address
456 Calle Cesar Gonzalez
San Juan, PR 00918-2628
Phone (787) 645-0089
Other practice location 1
456 Calle Cesar Gonzalez
San Juan, PR 00918-2628
Phone (787) 645-0089
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 582837989 | Medicaid | PR |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537401600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1537401600000",
"number": "1083198576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "456 CALLE CESAR GONZALEZ",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009182628",
"telephone_number": "787-645-0089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "456 CALLE CESAR GONZALEZ",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009182628",
"telephone_number": "787-645-0089"
}
],
"practiceLocations": [
{
"address_1": "456 Calle Cesar Gonzalez",
"address_purpose": "LOCATION",
"city": "San Juan",
"state": "PR",
"postal_code": "009182628",
"country_code": "US",
"telephone_number": "787-645-0089",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SAN JUAN DENTAL CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-09-20",
"last_updated": "2018-09-20",
"status": "A",
"authorized_official_last_name": "RODRIGUEZ",
"authorized_official_first_name": "ROSA",
"authorized_official_middle_name": "MARIA",
"authorized_official_title_or_position": "DOCTOR",
"authorized_official_telephone_number": "787-645-0089",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "582837989",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.