Individual provider Active NPI

Grettel Delgadillo Esparza, DDS

  • Dentist
  • San Diego, CA
National Provider Identifier
1063005783
Registry record updated Feb 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
105857 Issued in CA
Practice address
2225 Mabuhay Way
San Diego, CA 92154-1553
Phone
(619) 410-6069
NPI assigned
Feb 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 105857 CA Primary

Addresses

Primary practice location

2225 Mabuhay Way
San Diego, CA 92154-1553

Mailing address

2225 Mabuhay Way
San Diego, CA 92154-1553
Phone (619) 410-6069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
105857CAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613174400000",
    "number": "1063005783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 MABUHAY WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921541553",
            "telephone_number": "619-410-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 MABUHAY WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921541553",
            "telephone_number": "619-410-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADILLO ESPARZA",
        "first_name": "GRETTEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-13",
        "last_updated": "2021-02-13",
        "certification_date": "2021-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.