Individual provider Active NPI

Guillermo Cecilio Jauregui Rodriguez, D.D.S.

  • General Practice Dentistry
  • Miami, FL
National Provider Identifier
1124375647
Registry record updated Jan 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN21055 Issued in FL
Practice address
957 NW 128TH PL
Miami, FL 33182-2319
Phone
(305) 689-6725
NPI assigned
Aug 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DRP1100 FL
General Practice Dentistry 1223G0001X DN21055 FL Primary

Addresses

Primary practice location

957 NW 128TH PL
Miami, FL 33182-2319

Mailing address

957 NW 128TH PL
Miami, FL 33182-2319
Phone (786) 838-6218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160928001654 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5395032866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DRP1100FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422057600000",
    "number": "1124375647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "957 NW 128TH PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331822319",
            "telephone_number": "786-838-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "957 NW 128TH PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331822319",
            "telephone_number": "305-689-6725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAUREGUI RODRIGUEZ",
        "first_name": "GUILLERMO",
        "middle_name": "CECILIO",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-15",
        "last_updated": "2015-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DRP1100",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN21055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.