Active NPI
Henry Camilo Cisneros Jr., DDS
- General Practice Dentistry
- Visalia, CA
National Provider Identifier
1073669503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 29239
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 29239 | CA | MD | Marriage & Family Therapist |
Interoperability endpoints
- 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.