Jorge L Delvalle, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02479400 Issued in NJ

Practice address

25 Ave at Port Imperial
Apt. 621
West New York, NJ 07093-8350

Phone

(201) 803-6647

NPI assigned

Aug 24, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1205116175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 AVE AT PORT IMPERIAL",
            "address_2": "APT. 621",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070938350",
            "telephone_number": "201-803-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 AVE AT PORT IMPERIAL",
            "address_2": "APT. 621",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070938350",
            "telephone_number": "201-803-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELVALLE",
        "first_name": "JORGE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02479400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• D.C.R.C. Corp (continental drugs)
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• Ketty Acasia Davila, RN- PMHNP STUDENT
• Maria Jose De la Hoz, D.D.S
• Dennis L. Aponte, M.D., LLC
• Dentistry for All Wny LLC
• Deramo Medical LLC (Deramo Orthopaedics)
• David Michael Deramo, M.D.
• Devaria LLC (The Galaxy Drug Store)

• General Practice Dentistry in West New York, NJ
• Providers in West New York, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; 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.