Juan Carlos Defex, DDS PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

043060-1 Issued in NY

Legal business name

JUAN CARLOS DEFEX, DDS PLLC

Practice address

7410 35TH Ave
Suite 106W
Jackson Heights, NY 11372-8197

Phone

(718) 476-6750

Fax

(718) 426-4040

NPI assigned

Oct 8, 2010

Organization subpart

No

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

Authorized official

Name

Juan Carlos Defex, DDSNPI 1821052317

Title

Owner

Phone

(718) 476-6750

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Juan Carlos De Fex, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Jackson Heights, NY
  • NPI 1821052317
  NPD (past) Authorized official

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286496000000",
    "number": "1437469459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7410 35TH AVE",
            "address_2": "SUITE 106W",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113728197",
            "telephone_number": "718-476-6750",
            "fax_number": "718-426-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7410 35TH AVE",
            "address_2": "SUITE 106W",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113728197",
            "telephone_number": "718-476-6750",
            "fax_number": "718-426-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUAN CARLOS DEFEX, DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-08",
        "last_updated": "2010-10-08",
        "status": "A",
        "authorized_official_last_name": "DEFEX",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "CARLOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-476-6750",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "043060-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01407450",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; 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.