Active NPI
Juan Pablo Perez, DDS
- Dentist
- Saint Paul, MN
National Provider Identifier
1164213021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- R896
- Practice address
- 451 Dunlap St N
Saint Paul, MN 55104-4619 - Phone
- (952) 967-7886
- NPI assigned
- May 13, 2025
- 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 | R896 | MN | Primary |
Addresses
Primary practice location
451 Dunlap St N
Saint Paul, MN 55104-4619
Mailing address
9155 101St Ave
Vero Beach, FL 32967-3032
Phone (772) 501-3544
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- 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 |
|---|---|---|---|---|
| I20250606002846 | MN | Order and Referring Only - Dentist | 2466962675 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R896 | MN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747094400000",
"number": "1164213021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9155 101ST AVE",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329673032",
"telephone_number": "772-501-3544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 DUNLAP ST N",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551044619",
"telephone_number": "952-967-7886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "JUAN",
"middle_name": "PABLO",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-05-13",
"last_updated": "2025-05-13",
"certification_date": "2025-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "R896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.