Individual provider Active NPI

Jose Eduardo Milan, D.D.S.

  • General Practice Dentistry
  • San Juan, PR
National Provider Identifier
1679697353
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1264 Issued in PR
Practice address
Ashford Medical Center Suite 108a
Washington Street Num 29
San Juan, PR 00907
Phone
(787) 723-8447
Fax
(787) 723-8447
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1264 PR Primary

Addresses

Primary practice location

Ashford Medical Center Suite 108a
Washington Street Num 29
San Juan, PR 00907

Mailing address

P.O.Box 6736 Loiza Station
San Juan, PR 00914
Phone (787) 723-8447

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
I20160523001864 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3577852037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1264PRMDNutritionist

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679697353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O.BOX 6736 LOIZA STATION",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00914",
            "telephone_number": "787-723-8447",
            "fax_number": "787-723-8447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ASHFORD MEDICAL CENTER SUITE 108A",
            "address_2": "WASHINGTON STREET NUM 29",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00907",
            "telephone_number": "787-723-8447",
            "fax_number": "787-723-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILAN",
        "first_name": "JOSE",
        "middle_name": "EDUARDO",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.