Esther Jimenez, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901016615 Issued in MI

Practice address

2755 Fuller Ave NE
Grand Rapids, MI 49505-3780

Phone

(616) 363-1136

Fax

(616) 363-4345

NPI assigned

Aug 16, 2006

Last updated

Apr 14, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: esther.jimenez.p1@direct.cherryhealth.nextgenshare.com

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.

• Fuller Avenue Dental Associates

  • General Practice Dentistry
  • Grand Rapids, MI
  • NPI 1639397615
  NPD (past)
• Harvester Dental

  • General Practice Dentistry
  • Grand Rapids, MI
  • NPI 1730539818
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1669585303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 FULLER AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053780",
            "telephone_number": "616-363-1136",
            "fax_number": "616-363-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 FULLER AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053780",
            "telephone_number": "616-363-1136",
            "fax_number": "616-363-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ESTHER",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901016615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4525364",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4085599",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina Jewell, CFO
• Briana Elise Jibson, LPC
• Jill Dubridge Counseling
• Andrea Jimenez Gutierrez, MD
• Yarixa Jimenez-Colon
• Lissette Jimenez, MD
• Maria Elena Jimenez
• Priscilla Jimenez, PMHNP-BC
• Raelynn Jimenez
• Reyna Doris Mae Jimenez

• General Practice Dentistry in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.