NPIMap

Organization Active NPI

San Juan Endodontics PSC

  • Dental Clinic/Center
  • San Juan, PR
National Provider Identifier
1336544857
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
2008 Issued in PR
Legal business name
SAN JUAN ENDODONTICS PSC
Practice address
1738 Calle Amarillo
Suite 207-B (Box 16)
San Juan, PR 00926-3072
Phone
(787) 765-7248
NPI assigned
Oct 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2014

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

Authorized official

Name
Dr. Jose Agustin Medina, DMDNPI 1073630760
Title
Ceo
Phone
(787) 765-7248

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 2008 PR Primary

Addresses

Primary practice location

1738 Calle Amarillo
Suite 207-B (Box 16)
San Juan, PR 00926-3072

Mailing address

1738 Amarillo St.
Box 16
San Juan, PR 00926
Phone (787) 765-7248

National Provider Directory

National Provider Directory

Locations

1738 Calle Amarillo
Ste 16
San Juan, PR 00926
Phone (787) 765-7248

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1336544857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1738 AMARILLO ST.",
            "address_2": "BOX 16",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-765-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1738 CALLE AMARILLO",
            "address_2": "SUITE 207-B (BOX 16)",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009263072",
            "telephone_number": "787-765-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN ENDODONTICS PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "AGUSTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "787-765-7248",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "PR",
            "license": "2008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.