Individual provider Active NPI

Joelyz Patino, DMD

  • Dentist
  • Doral, FL
National Provider Identifier
1962630103
Registry record updated Jun 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18786 Issued in FL
Practice address
3650 NW 82ND Ave Ste 204-05
Doral, FL 33166-6658
Phone
(305) 722-0605
NPI assigned
Jun 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18786 FL Primary

Addresses

Primary practice location

3650 NW 82ND Ave Ste 204-05
Doral, FL 33166-6658

Mailing address

4525 W 20TH Ave Apt C328
Hialeah, FL 33012-2804
Phone (305) 820-9383

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160302001081 FL Order and Referring Only - DentistPractitioner - Dentist 0749586634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18786FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
J Family Dental Current Accepting new patients

Organizations & group practices 1

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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246147200000",
    "number": "1962630103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 W 20TH AVE APT C328",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330122804",
            "telephone_number": "305-820-9383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 NW 82ND AVE STE 204-05",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666658",
            "telephone_number": "305-722-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATINO",
        "first_name": "JOELYZ",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "18786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.