Juan Carlos De Fex, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

043060 Issued in NY

Practice address

74-10 35TH Avenue
Suite 106W
Jackson Heights, NY 11372-8160

Phone

(718) 476-6750

Fax

(718) 426-4040

NPI assigned

Apr 13, 2006

Last updated

Jul 1, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 22, 2021 through Oct 22, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Juan Carlos Defex, DDS PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Jackson Heights, NY
  • NPI 1437469459
  NPD (past) Authorized official

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246406400000",
    "number": "1821052317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74-10 35TH AVENUE",
            "address_2": "SUITE 106W",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113728160",
            "telephone_number": "718-476-6750",
            "fax_number": "718-426-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74-10 35TH AVENUE",
            "address_2": "SUITE 106W",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113728160",
            "telephone_number": "718-476-6750",
            "fax_number": "718-426-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE FEX",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2009-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "043060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01407450",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sharon Brooke De Marco, LMSW

• Oral and Maxillofacial Surgery (Dentist) in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.