Individual provider Active NPI

Juan Diego Ramirez de Arellano

  • Endodontics
  • Bayamon, PR
National Provider Identifier
1376125658
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
3435 Issued in PR
Practice address
Carr. 167 KM 22.2
Plaza Tropical #11
Bayamon, PR 00929
Phone
(787) 641-1340
NPI assigned
Apr 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 3435 PR Primary

Addresses

Primary practice location

Carr. 167 KM 22.2
Plaza Tropical #11
Bayamon, PR 00929

Mailing address

55 Calle de Diego E Ste 206
Mayaguez, PR 00680-5080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251205002363 PR Order and Referring Only - DentistPractitioner - Dentist 4183117203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3435PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Endorap LLC Endodontics CurrentSince Aug 18, 2024 Accepting new patients

Locations

55 Calle de Diego E
Ste 206
Mayaguez, PR 00680
Phone (787) 375-4425

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1376125658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CALLE DE DIEGO E STE 206",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006805080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 167 KM 22.2",
            "address_2": "PLAZA TROPICAL #11",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00929",
            "telephone_number": "787-641-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMIREZ DE ARELLANO",
        "first_name": "JUAN",
        "middle_name": "DIEGO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-26",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PR",
            "license": "3435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.