Individual provider Active NPI

Josean Martinez, D.M.D

  • Dentist
  • San Juan, PR
National Provider Identifier
1740405471
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2712 Issued in PR
Practice address
735 Ave. Ponce de Leon Torre del Auxilio Mutuo
Suite 504
San Juan, PR 00917
Phone
(787) 607-6171
NPI assigned
Apr 16, 2007
Last updated
Apr 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2712 PR Primary

Addresses

Primary practice location

735 Ave. Ponce de Leon Torre del Auxilio Mutuo
Suite 504
San Juan, PR 00917

Mailing address

735 Ave Ponce de Leon
Ste 504
San Juan, PR 00917-5026
Phone (787) 777-6701

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
I20160425000903 PR Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 5496054512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2712PRMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Endodoncia Y Periodoncia del Caribe Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1740405471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 AVE PONCE DE LEON",
            "address_2": "STE 504",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175026",
            "telephone_number": "787-777-6701",
            "fax_number": "787-777-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 AVE. PONCE DE LEON TORRE DEL AUXILIO MUTUO",
            "address_2": "SUITE 504",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00917",
            "telephone_number": "787-607-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JOSEAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "2712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.