Healthcare Provider Details

I. General information

NPI: 1417498155
Provider Name (Legal Business Name): JESSICA JUNQUERA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2017
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7480 SW 40TH ST STE 500
MIAMI FL
33155-6638
US

IV. Provider business mailing address

7480 SW 40TH ST SUITE 500
MIAMI FL
33155-6600
US

V. Phone/Fax

Practice location:
  • Phone: 305-551-8200
  • Fax: 305-551-8220
Mailing address:
  • Phone: 305-551-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN20756
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDN20756
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: