Active NPI
Mauricio Gomez Jr., DDS
- General Practice Dentistry
- Jupiter, FL
National Provider Identifier
1104016237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN12500
- Practice address
- 103 S US Highway 1
Ste D4
Jupiter, FL 33477-5132 - Phone
- (561) 746-2646
- NPI assigned
- Jul 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN12500 | FL | Primary |
Addresses
Primary practice location
103 S US Highway 1
Ste D4
Jupiter, FL 33477-5132
Mailing address
103 S US Highway 1
Ste D4
Jupiter, FL 33477-5132
Phone (561) 746-2646
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN12500 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185321600000",
"number": "1104016237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 S US HIGHWAY 1",
"address_2": "STE D4",
"city": "JUPITER",
"state": "FL",
"postal_code": "334775132",
"telephone_number": "561-746-2646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 S US HIGHWAY 1",
"address_2": "STE D4",
"city": "JUPITER",
"state": "FL",
"postal_code": "334775132",
"telephone_number": "561-746-2646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "MAURICIO",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-25",
"last_updated": "2007-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN12500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jupiter, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.