Individual provider Active NPI

Jesus M Negron Vives, DMD

  • Dentist
  • Jayuya, PR
National Provider Identifier
1740358944
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
925 Issued in PR
Practice address
Guillermo Esteves 103 Altos
Jayuya, PR 00664
Phone
(787) 828-6400
Fax
(787) 828-6400
NPI assigned
Dec 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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
Dentist 122300000X 925 PR Primary

Addresses

Primary practice location

Guillermo Esteves 103 Altos
Jayuya, PR 00664

Mailing address

Box 794
Jayuya, PR 00664
Phone (787) 828-6400

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
I20160401000659 PR Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 9133426356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
925PRMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740358944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 794",
            "city": "JAYUYA",
            "state": "PR",
            "postal_code": "00664",
            "telephone_number": "787-828-6400",
            "fax_number": "787-828-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GUILLERMO ESTEVES 103 ALTOS",
            "city": "JAYUYA",
            "state": "PR",
            "postal_code": "00664",
            "telephone_number": "787-828-6400",
            "fax_number": "787-828-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGRON VIVES",
        "first_name": "JESUS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jayuya, PR

Sources for this page

Verify at the official NPI Registry.