Individual provider Active NPI

Javier Antonio Rivera Quintero, D.M.D.

  • General Practice Dentistry
  • San Juan, PR
National Provider Identifier
1962058990
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3361 Issued in PR
Practice address
456 Calle Tnte Cesar Gonzalez
San Juan, PR 00918-2628
Phone
(787) 753-2376
Fax
(787) 767-8392
NPI assigned
Aug 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3361 PR Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

456 Calle Tnte Cesar Gonzalez
San Juan, PR 00918-2628

Mailing address

323 Camino del Guama
Sabanera Dorado
Dorado, PR 00646
Phone (787) 626-6581

Other practice location 1

10 Calle Casia
San Juan, PR 00921-3201
Phone (787) 641-7582

Other practice location 2

37 Carr 778 Pabellon de Servicios
Clinica Dental
Comerio, PR 00778-2922
Phone (787) 875-2190

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210929003756 PR Practitioner - Dentist 6901203116 Practice locations: San Juan, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3361PRMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1962058990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 CAMINO DEL GUAMA",
            "address_2": "SABANERA DORADO",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "00646",
            "telephone_number": "787-626-6581",
            "fax_number": "787-626-6581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 CALLE TNTE CESAR GONZALEZ",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009182628",
            "telephone_number": "787-753-2376",
            "fax_number": "787-767-8392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Calle Casia",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "009213201",
            "country_code": "US",
            "telephone_number": "787-641-7582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37 Carr 778 Pabellon de Servicios",
            "address_2": "Clinica Dental",
            "address_purpose": "LOCATION",
            "city": "Comerio",
            "state": "PR",
            "postal_code": "007782922",
            "country_code": "US",
            "telephone_number": "787-875-2190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA QUINTERO",
        "first_name": "JAVIER",
        "middle_name": "ANTONIO",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-15",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "3361",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.