Jetzabel Medina Perez, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

111528 Issued in CA

Practice address

255 S Grand Ave Ste 204
Los Angeles, CA 90012-3035

Phone

(213) 620-5777

NPI assigned

Jul 18, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Don Mungcal DDS Brentwood Inc.

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1407636335
  NPD
• Don Mungcal, D.D.S., Inc.

  • General Practice Dentistry
  • Manhattan Beach, CA
  • NPI 1003133109
  NPD (past)

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

{
    "created_epoch": "1752796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1073405445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S OLIVE ST APT 402",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900124902",
            "telephone_number": "626-806-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S GRAND AVE STE 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900123035",
            "telephone_number": "213-620-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA PEREZ",
        "first_name": "JETZABEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-18",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "111528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medigence Health PC
• Medimanage LLC
• Lilian Aracely Medina del Rio, PSY.D.
• Chie Medina Koshikawa
• Luis Guillermo Medina Navarro, MD
• Jazmin Irasema Medina Piedra
• Hilario Medina Ramirez, MD
• Lizeth Medina-Camello, FNP-BC
• Waleska Medina-Cannon
• Stephanie Medina-Gomez

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.