Active NPI
Raul Perez, D.D.S.
- Pediatric Dentistry
- Jacksonville, FL
National Provider Identifier
1316935810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN 11861
- Practice address
- 2771 Monument Rd
Suite #23
Jacksonville, FL 32225-5549 - Phone
- (904) 645-9555
- Fax
- (904) 641-5291
- NPI assigned
- Oct 10, 2005
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN 11861 | FL | Primary |
Addresses
Primary practice location
2771 Monument Rd
Suite #23
Jacksonville, FL 32225-5549
Mailing address
2771 Monument Rd
Suite #23
Jacksonville, FL 32225-5549
Phone (904) 645-9555
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 11861 | FL | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1316935810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2771 MONUMENT RD",
"address_2": "SUITE #23",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322255549",
"telephone_number": "904-645-9555",
"fax_number": "904-641-5291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2771 MONUMENT RD",
"address_2": "SUITE #23",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322255549",
"telephone_number": "904-645-9555",
"fax_number": "904-641-5291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "RAUL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-10",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "DN 11861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.