Pesantes, Juan Jose

Pesantes, Juan Jose is an individual health care provider with primary practice located at 4104 102Nd St 2Nd Floor, Corona NY 11368-2480. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Pesantes, Juan Jose can be contacted via phone (718) 651-3939.

Contact Information

Primary practice address
4104 102Nd St 2Nd Floor Corona NY 11368-2480
Phone: (718) 651-3939
Fax: (718) 651-0159
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 046461 New York

Profile Details

NPI number 1225208101
LBN Legal business name Pesantes, Juan Jose
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2008
Last updated Feb 1st, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225208101 NPPES
New York MEDICAID 01738614

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