Individual provider Active NPI

Juan Quintanar Caballero, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1396936506
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
043152-1 Issued in NY
Practice address
1456 Fulton St
Brooklyn, NY 11216-2505
Phone
(718) 636-4500
Fax
(347) 296-8363
NPI assigned
Aug 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 043152-1 NY Primary

Addresses

Primary practice location

1456 Fulton St
Brooklyn, NY 11216-2505

Mailing address

1456 Fulton St
Brooklyn, NY 11216-2505
Phone (718) 636-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20201008000454 NY Order and Referring Only - DentistPractitioner - Dentist 0648699827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043152-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bedford Stuyvesant Family Health Center, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DFDFAA

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": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1396936506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162505",
            "telephone_number": "718-636-4500",
            "fax_number": "347-296-8363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162505",
            "telephone_number": "718-636-4500",
            "fax_number": "347-296-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANAR CABALLERO",
        "first_name": "JUAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "043152-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.