Individual provider Active NPI

Jacqueline M Bigas Mendez, DMD

  • Dentist
  • Ponce, PR
National Provider Identifier
1679574040
Registry record updated Aug 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1208 Issued in PR
Practice address
1496 Paseo Fagot
Ponce, PR 00716-2304
Phone
(787) 843-5858
NPI assigned
Aug 9, 2005
Last updated
Aug 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1208 PR Primary

Addresses

Primary practice location

1496 Paseo Fagot
Ponce, PR 00716-2304

Mailing address

PO Box 56
Mercedita, PR 00715-0056
Phone (787) 843-5858

Other identifiers 2

IdentifierTypeStateIssuer
41275 BIOtherPRTRIPLE SSS
041013OtherPRCRUZ AZUL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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

Enrollment IDStateProvider typePAC IDDetails
I20170926001673 PR Order and Referring Only - DentistPractitioner - Dentist 2860766169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502928000000",
    "number": "1679574040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 56",
            "city": "MERCEDITA",
            "state": "PR",
            "postal_code": "007150056",
            "telephone_number": "787-843-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1496 PASEO FAGOT",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007162304",
            "telephone_number": "787-843-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIGAS MENDEZ",
        "first_name": "JACQUELINE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2017-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "1208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE SSS",
            "identifier": "41275 BI",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL",
            "identifier": "041013",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.