MEDICARE: ENDODONTIC CARE SPECIALTY GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist
2	1223E0200X	Endodontics

General Provider Information

NPI Number	:	1437093309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENDODONTIC CARE SPECIALTY GROUP LLC

Provider Business Mailing Address
First Line	:	394 CALLE JACANA
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-7155
Country	:	US
Telephone Number	:	787-420-9979
Fax Number	:

Provider Business Practice Location Address
First Line	:	394 CALLE JACANA
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-7155
Country	:	US
Telephone Number	:	787-420-9979
Fax Number	:

Authorized Official
Title or Position	:	DENTIST/ENDODONTIST
Name	:	DR. MANUEL ALEJANDRO PEREA CUEBAS
Credential	:	DMD
Telephone Number	:	787-420-9979

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

Similar Medicare Providers

1093076473 — KC CRAWFORD
Practice Location Address:

7155 MISSION GORGE RD
SAN DIEGO, CA
92120-1130

Practice Phone: 858-300-0460
Practice Fax: 858-300-0461

1093797458 — DR. CHRISTINA F SHORT M.D.
Practice Location Address:

3301 W SAN JOSE ST
TAMPA, FL
33629-7155

Practice Phone: 813-835-6465
Practice Fax:

1588723555 — MRS. MARIA ARACELI VIEYRA
Practice Location Address:

7155 FALLEN TRAIL DR
SAN ANTONIO, TX
78244-1815

Practice Phone: 210-666-1465
Practice Fax: 210-666-1465

1770629545 — MRS. TONYA M JENKINS B.S.
Practice Location Address:

7155 MISSION GORGE RD
SAN DIEGO, CA
92120-1130

Practice Phone: 858-300-0460
Practice Fax: 858-300-0461

1376685594 — LILI'A CHRISTA FA'AOLA BA
Practice Location Address:

7155 MISSION GORGE RD
SAN DIEGO, CA
92120-1130

Practice Phone: 858-300-0460
Practice Fax: 858-300-0461

1033399431 — MIGUEL F RAMOS
Practice Location Address:

7155 HWY 90 W
SAN ANTONIO, TX
78227-3535

Practice Phone: 210-678-0751
Practice Fax: 210-678-0683

Directions to “ENDODONTIC CARE SPECIALTY GROUP LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.