Libia Rebeca Jimenez, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

045307-1 Issued in NY

Practice address

600 W 146TH St
Ground Floor
New York, NY 10031-4301

Phone

(212) 368-9532

Fax

(212) 368-2245

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ethics Dental Ipa, Inc

  • General Practice Dentistry
  • New York, NY
  • NPI 1144517525
  NPD (past) Authorized official
• LJ Professional Dental PC

  • Pediatric Dentistry
  • New York, NY
  • NPI 1588877591
  NPD (past) Authorized official

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578636668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W 146TH ST",
            "address_2": "GROUND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100314301",
            "telephone_number": "212-368-9532",
            "fax_number": "212-368-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W 146TH ST",
            "address_2": "GROUND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100314301",
            "telephone_number": "212-368-9532",
            "fax_number": "212-368-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "LIBIA",
        "middle_name": "REBECA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "045307-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01477283",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerisel Jimenez, LCSW
• Jessica Jimenez, PA-C
• Josue Jimenez, ARNP
• Kaila Marie Jimenez
• Kevin Alberto Jimenez
• Lorena C Jimenez, PA
• Lucila Jimenez, M.A., M.PHIL.
• Luz M Jimenez, MD
• Maciel Jimenez
• Maribel Jimenez, FNP-BC

• Pediatric Dentistry in New York, NY
• Providers in New York, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.