Individual provider Active NPI

Juan Eugenio Perez Solar, DDS

  • General Practice Dentistry
  • Hialeah, FL
National Provider Identifier
1770658304
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN15474 Issued in FL
Practice address
5323 West 20TH Ave
Hialeah, FL 33012
Phone
(305) 556-5966
Fax
(305) 556-5976
NPI assigned
Nov 21, 2006
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
General Practice Dentistry 1223G0001X DN15474 FL Primary

Addresses

Primary practice location

5323 West 20TH Ave
Hialeah, FL 33012

Mailing address

5323 West 20TH Ave
Hialeah, FL 33012
Phone (305) 556-5966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180116002399 FL Order and Referring Only - DentistPractitioner - Dentist 3779842992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jeps Dental Group LLC Current Accepting new patients
Marrecau Orthodontics LLC Past Accepting new patients

Locations

19517 NW 57th Ave
Miami Gardens, FL 33055
Phone (305) 621-3111

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770658304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 WEST 20TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "33012",
            "telephone_number": "305-556-5966",
            "fax_number": "305-556-5976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 WEST 20TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "33012",
            "telephone_number": "305-556-5966",
            "fax_number": "305-556-5976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ SOLAR",
        "first_name": "JUAN",
        "middle_name": "EUGENIO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN15474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.