Individual provider Active NPI

Carolina Jimenez Soto, DMD

  • Dentist
  • Quebradillas, PR
National Provider Identifier
1407196355
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
057430-1 Issued in NY
Practice address
42032 Sect Piquinas
Quebradillas, PR 00678-9492
Phone
(787) 396-2542
NPI assigned
Feb 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 057430-1 NY Primary

Addresses

Primary practice location

42032 Sect Piquinas
Quebradillas, PR 00678-9492

Mailing address

42032 Sect Piquinas
Quebradillas, PR 00678-9492
Phone (787) 396-2542

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
I20180315001095 NY Order and Referring Only - DentistPractitioner - Dentist 9335401199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1407196355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42032 SECT PIQUINAS",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "006789492",
            "telephone_number": "787-396-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42032 SECT PIQUINAS",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "006789492",
            "telephone_number": "787-396-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ SOTO",
        "first_name": "CAROLINA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-28",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057430-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quebradillas, PR

Sources for this page

Verify at the official NPI Registry.