Individual provider Active NPI

Ricardo Javier Jimenez-Bosch, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • San Juan, PR
National Provider Identifier
1891998621
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
2660 Issued in PR
Practice address
Doral Financial Plaza 1451 Roosevelt Avenue
Suite 800
San Juan, PR 00920
Phone
(787) 210-0555
NPI assigned
Jun 8, 2007
Sex
Male
Sole proprietor
Yes

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
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2660 PR Primary

Addresses

Primary practice location

Doral Financial Plaza 1451 Roosevelt Avenue
Suite 800
San Juan, PR 00920

Mailing address

Doral Financial Plaza 1451 Roosevelt Avenue
Suite 800
San Juan, PR 00920
Phone (787) 210-0555

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070723000526 PR Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 3274634100 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica de Cirugia Oral Y Maxilofacial de Caparra CSP CurrentSince Apr 4, 2015 Accepting new patients
Clinica de Cirugia Oral Y Maxilofacial de Caparra Corp PastSince Apr 4, 2015 Accepting new patients

Locations

33 Calle Resolucion
Ste 800
San Juan, PR 00920
Phone (787) 603-5170

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": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891998621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DORAL FINANCIAL PLAZA 1451 ROOSEVELT AVENUE",
            "address_2": "SUITE 800",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00920",
            "telephone_number": "787-210-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DORAL FINANCIAL PLAZA 1451 ROOSEVELT AVENUE",
            "address_2": "SUITE 800",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00920",
            "telephone_number": "787-210-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ-BOSCH",
        "first_name": "RICARDO",
        "middle_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PR",
            "license": "2660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.