Active NPI
Juan Manuel Ojeda Jr., DMD
- Pediatric Dentistry
- Miami Gardens, FL
National Provider Identifier
1861786949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN19477
- Practice address
- 17301 NW 27TH Ave
Miami Gardens, FL 33056-4001 - Phone
- (305) 624-1371
- NPI assigned
- Jun 6, 2011
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN19477 | FL | Primary |
Addresses
Primary practice location
17301 NW 27TH Ave
Miami Gardens, FL 33056-4001
Mailing address
103 Ranch Rd
Winter Park, FL 32792-5712
Phone (407) 797-1543
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004452600 | Medicaid | FL |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160606001072 | FL | Order and Referring Only - Oral Surgery | 2860782745 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN19477 | FL | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467244800000",
"number": "1861786949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 RANCH RD",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327925712",
"telephone_number": "407-797-1543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17301 NW 27TH AVE",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "330564001",
"telephone_number": "305-624-1371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OJEDA",
"first_name": "JUAN",
"middle_name": "MANUEL",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-06",
"last_updated": "2016-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "DN19477",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004452600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.