Individual provider Active NPI

Tania Jaramillo, DDS

  • General Practice Dentistry
  • Orange, CA
National Provider Identifier
1063374643
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS111801 Issued in CA
Practice address
130 S Main St Ste a-D
Orange, CA 92868-2869
Phone
(657) 218-5865
NPI assigned
Dec 2, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DDS111801 CA Primary

Addresses

Primary practice location

130 S Main St Ste a-D
Orange, CA 92868-2869

Mailing address

16245 Derian Ave
Irvine, CA 92614-0164
Phone (714) 317-4977

Other practice location 1

13327 Florence Ave
Santa Fe Springs, CA 90670
Phone (562) 232-4715

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
DDS111801CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Elmira Latshikyan Dental Corporation General Practice CurrentSince Dec 7, 2025 Accepting new patients
Santa Fe Springs Modern Dentistry, Inc General Practice PastSince Mar 11, 2025 Accepting new patients

Locations

130 S Main St
Ste Ad
Orange, CA 92868
Phone (657) 218-5865

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1764633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1063374643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16245 DERIAN AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926140164",
            "telephone_number": "714-317-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S MAIN ST STE A-D",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682869",
            "telephone_number": "657-218-5865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13327 Florence Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Fe Springs",
            "state": "CA",
            "postal_code": "90670",
            "country_code": "US",
            "telephone_number": "562-232-4715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JARAMILLO",
        "first_name": "TANIA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-02",
        "last_updated": "2025-12-02",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS111801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.