Individual provider Active NPI

Jesus Enrique Delvalle, D.D.S.

  • Dentist
  • Coral Gables, FL
National Provider Identifier
1508038290
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN0012142 Issued in FL
Practice address
2030 S Douglas Rd Apt 213
Coral Gables, FL 33134-4620
Phone
(305) 442-1094
Fax
(786) 497-1725
NPI assigned
Apr 2, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN0012142 FL Primary

Addresses

Primary practice location

2030 S Douglas Rd Apt 213
Coral Gables, FL 33134-4620

Mailing address

2030 S Douglas Rd Apt 213
Coral Gables, FL 33134-4620
Phone (305) 442-1094

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
DN0012142FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1508038290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 S DOUGLAS RD APT 213",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344620",
            "telephone_number": "305-442-1094",
            "fax_number": "786-497-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 S DOUGLAS RD APT 213",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344620",
            "telephone_number": "305-442-1094",
            "fax_number": "786-497-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELVALLE",
        "first_name": "JESUS",
        "middle_name": "ENRIQUE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN0012142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.