Individual provider Active NPI

Clara E De Jesus, DMD

  • Endodontics
  • San Juan, PR
National Provider Identifier
1114923653
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
1750 Issued in PR
Practice address
570 Calle Napoles
Ste 203
San Juan, PR 00924-4605
Phone
(787) 760-3260
Fax
(787) 748-5177
NPI assigned
Jun 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 1750 PR Primary

Addresses

Primary practice location

570 Calle Napoles
Ste 203
San Juan, PR 00924-4605

Mailing address

570 Calle Napoles
Ste 203
San Juan, PR 00924-4605
Phone (787) 760-3260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20240108005817 PR Order and Referring Only - EndodonticsPractitioner - Endodontics 5092024935

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1750PRMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114923653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 CALLE NAPOLES",
            "address_2": "STE 203",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009244605",
            "telephone_number": "787-760-3260",
            "fax_number": "787-748-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 CALLE NAPOLES",
            "address_2": "STE 203",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009244605",
            "telephone_number": "787-760-3260",
            "fax_number": "787-748-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "CLARA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PR",
            "license": "1750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.