Individual provider Active NPI

Jacob Richard Orozco, D.M.D., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Philadelphia, PA
National Provider Identifier
1164750352
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DS037207 Issued in PA
Practice address
6404 Roosevelt Blvd
2ND Floor
Philadelphia, PA 19149-2943
Phone
(215) 743-4700
Fax
(215) 743-3706
NPI assigned
Nov 26, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DS037207 PA Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DI02430800 NJ

Addresses

Primary practice location

6404 Roosevelt Blvd
2ND Floor
Philadelphia, PA 19149-2943

Mailing address

2021 Green St
Apt 2
Philadelphia, PA 19130-3457
Phone (267) 303-9494

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DI02430800NJMDOrthodontics and Dentofacial Orthopedic Dentist
DS037207PAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1259193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1164750352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 GREEN ST",
            "address_2": "APT 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303457",
            "telephone_number": "267-303-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 ROOSEVELT BLVD",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492943",
            "telephone_number": "215-743-4700",
            "fax_number": "215-743-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OROZCO",
        "first_name": "JACOB",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-26",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DS037207",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "DI02430800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.