Individual provider Active NPI

Juana M Geldres, DDS, PA

  • General Practice Dentistry
  • West Palm Beach, FL
National Provider Identifier
1649212796
Registry record updated Mar 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN16169 Issued in FL
Practice address
1911 Forest Hill Blvd
West Palm Beach, FL 33406
Phone
(561) 439-7400
Fax
(561) 439-7443
NPI assigned
Jun 12, 2006
Last updated
Mar 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN16169 FL Primary

Addresses

Primary practice location

1911 Forest Hill Blvd
West Palm Beach, FL 33406

Mailing address

1911 Forest Hill Blvd
West Palm Beach, FL 33406
Phone (561) 439-7400

Other identifiers 1

IdentifierTypeStateIssuer
007523100MedicaidFL

Other names 1

  • Juana M Geldres Professional name

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
DN16169FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Juana M Geldres DDS PA CurrentSince Dec 15, 2024 Accepting new patients

Locations

1911 Forest Hill Blvd
West Palm Beach, FL 33406
Phone (561) 439-7400

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551398400000",
    "number": "1649212796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 FOREST HILL BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33406",
            "telephone_number": "561-439-7400",
            "fax_number": "561-439-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 FOREST HILL BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33406",
            "telephone_number": "561-439-7400",
            "fax_number": "561-439-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELDRES",
        "first_name": "JUANA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS, PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2019-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007523100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUANA",
            "last_name": "GELDRES",
            "middle_name": "M",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Mar 1, 2019; 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.