NPIMap

Organization Active NPI

Boutique Dental

  • General Practice Dentistry
  • Bayamon, PR
National Provider Identifier
1235765983
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BOUTIQUE DENTAL
Practice address
Urb Royal Town Ave Las Cumbres A20
Bayamon, PR 00956
Phone
(787) 428-6363
Fax
(787) 799-5052
NPI assigned
Mar 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Authorized official

Name
Jessica Rivera Cruz
Title
Secretary
Phone
(787) 428-6363

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X
ProsthodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0700X

Addresses

Primary practice location

Urb Royal Town Ave Las Cumbres A20
Bayamon, PR 00956

Mailing address

Urb Royal Town Ave Las Cumbres A20
Bayamon, PR 00956
Phone (787) 428-6363

National Provider Directory

National Provider Directory
Tax ID family
Boutique Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584057600000",
    "number": "1235765983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB ROYAL TOWN AVE LAS CUMBRES A20",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00956",
            "telephone_number": "787-428-6363",
            "fax_number": "787-799-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB ROYAL TOWN AVE LAS CUMBRES A20",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00956",
            "telephone_number": "787-428-6363",
            "fax_number": "787-799-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUTIQUE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-13",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A",
        "authorized_official_last_name": "RIVERA CRUZ",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "787-428-6363"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.