Provider Demographics
NPI:1649276932
Name:DE JESUS VINAS, JAIME (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:
Last Name:DE JESUS VINAS
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 364771
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4771
Mailing Address - Country:US
Mailing Address - Phone:787-756-5912
Mailing Address - Fax:787-764-3441
Practice Address - Street 1:293 CALLE COLON - ROOSEVELT
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2701
Practice Address - Country:US
Practice Address - Phone:787-756-5912
Practice Address - Fax:787-764-3441
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0008331223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics