Individual provider Active NPI

Manuel Bienvenido Capriles Jaquez, DDS

  • Dentist
  • West Palm Beach, FL
National Provider Identifier
1407549124
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN28258 Issued in FL
Practice address
3540 Forest Hill Blvd Ste 203
West Palm Beach, FL 33406-5878
Phone
(561) 990-4058
NPI assigned
May 30, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN28258 FL Primary

Addresses

Primary practice location

3540 Forest Hill Blvd Ste 203
West Palm Beach, FL 33406-5878

Mailing address

4930 Forest Hill Ave Apt 304
Richmond, VA 23225-3103

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

LicenseStateTypeSpecialty
DN28258FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Capriles Dental LLC Current Accepting new patients

Networks

  • Freedom Health HMO Network

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": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1407549124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 FOREST HILL AVE APT 304",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232253103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 FOREST HILL BLVD STE 203",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334065878",
            "telephone_number": "561-990-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPRILES JAQUEZ",
        "first_name": "MANUEL",
        "middle_name": "BIENVENIDO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN28258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.