Active NPI
Josean Martinez, D.M.D
- Dentist
- San Juan, PR
National Provider Identifier
1740405471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2712
- 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, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160425000903 | PR | Order and Referring Only - Other (Physician) | 5496054512 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2712 | PR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Periodontics
- San Juan, PR
- NPI 1063660116
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.