Individual provider Active NPI

Henry Camilo Cisneros Jr., DDS

  • General Practice Dentistry
  • Visalia, CA
National Provider Identifier
1073669503
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29239 Issued in CA
Practice address
501 North Bridge Street
Visalia, CA 93291-5014
Phone
(559) 734-1939
Fax
(559) 734-4384
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

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 29239 CA Primary

Addresses

Primary practice location

501 North Bridge Street
Visalia, CA 93291-5014

Mailing address

305 East Center Ave.
Visalia, CA 93291-6331
Phone (559) 727-4700

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
29239CAMDMarriage & Family Therapist

Interoperability endpoints

  • Direct secure messaging: henry.cisneros@fhcn.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1073669503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 EAST CENTER AVE.",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916331",
            "telephone_number": "559-727-4700",
            "fax_number": "559-737-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 NORTH BRIDGE STREET",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915014",
            "telephone_number": "559-734-1939",
            "fax_number": "559-734-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "HENRY",
        "middle_name": "CAMILO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; 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.