Active NPI
Juan Ramon Miranda
- Dentist
- San Juan, PR
National Provider Identifier
1114944675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0921
- Practice address
- 71 Calle Arzuaga
San Juan, PR 00925-3703 - Phone
- (787) 765-5106
- Fax
- (787) 751-5626
- NPI assigned
- Jul 17, 2006
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 0921 | PR | Primary |
Addresses
Primary practice location
71 Calle Arzuaga
San Juan, PR 00925-3703
Mailing address
PO Box 21107
San Juan, PR 00928-1107
Phone (787) 765-5106
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150618000586 | PR | Order and Referring Only - Oral Surgery | 0143531095 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114944675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 21107",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009281107",
"telephone_number": "787-765-5106",
"fax_number": "787-751-5626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 CALLE ARZUAGA",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009253703",
"telephone_number": "787-765-5106",
"fax_number": "787-751-5626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "JUAN",
"middle_name": "RAMON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PR",
"license": "0921",
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.