Active NPI
Johanna Palacio, DMD
- Dentist
- New York, NY
National Provider Identifier
1932505963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 057419-1
- Practice address
- 30 W 60TH St Ste 1GH
New York, NY 10023-7902 - Phone
- (212) 246-3200
- NPI assigned
- Nov 19, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 057419-1 | NY | Primary |
Addresses
Primary practice location
30 W 60TH St Ste 1GH
New York, NY 10023-7902
Mailing address
30 W 60TH St Ste 1GH
New York, NY 10023-7902
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057419-1 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Juan C Jaramillo DDS PC | Dentist | Past | Accepting new patients |
| Juan C. Jaramillo D.D.S. P.C. | Dentist | Past | Accepting new patients |
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": "1416355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416355200000",
"number": "1932505963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 W 60TH ST STE 1GH",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100237902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 W 60TH ST STE 1GH",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100237902",
"telephone_number": "212-246-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALACIO",
"first_name": "JOHANNA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-19",
"last_updated": "2014-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "057419-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.