NPIMap

Organization Active NPI

JRC Maxillofacial Services,PSC

  • Oral and Maxillofacial Surgery (Dentist)
  • Fajardo, PR
National Provider Identifier
1689980682
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
995 Issued in PR
Legal business name
JRC MAXILLOFACIAL SERVICES,PSC
Practice address
Garrido Morales 53
Fajardo, PR 00738-1087
Phone
(787) 863-2549
NPI assigned
Aug 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

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

Authorized official

Name
Dr. Juan Ramon Rivera, DMDNPI 1073502860
Title
Presidente
Phone
(787) 852-4685

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 995 PR Primary

Addresses

Primary practice location

Garrido Morales 53
Fajardo, PR 00738-1087

Mailing address

6 Calle Flor Gerena N
Humacao, PR 00791-4293

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120423000377 PR Part B Supplier - Clinic/Group Practice 1153582911 Receives reassigned benefits from 1 practitioner
Practice locations: Fajardo, PR; Humacao, PR

National Provider Directory

National Provider Directory

Locations

53 Calle Garrido Morales E
Fajardo, PR 00738
Phone (787) 863-2549

6 Calle Flor Gerena N
Humacao, PR 00791
Phone (787) 852-4685

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282867200000",
    "number": "1689980682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CALLE FLOR GERENA N",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007914293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GARRIDO MORALES 53",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007381087",
            "telephone_number": "787-863-2549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JRC MAXILLOFACIAL SERVICES,PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-27",
        "last_updated": "2010-08-27",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "RAMON",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-852-4685",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PR",
            "license": "995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fajardo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.