Demetrio Dela Rosa Fernandez Jr., DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38678 Issued in CA

Practice address

25982 Pala Drive
Suite 130
Mission Viejo, CA 92691

Phone

(949) 829-8411

Fax

(949) 829-8650

NPI assigned

Mar 30, 2007

Sex

Male

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

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.

• Noni Dental Corporation

  • General Practice Dentistry
  • Mission Viejo, CA
  • NPI 1164175022
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104946490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25982 PALA DRIVE",
            "address_2": "SUITE 130",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-829-8411",
            "fax_number": "949-829-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25982 PALA DRIVE",
            "address_2": "SUITE 130",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-829-8411",
            "fax_number": "949-829-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "DEMETRIO",
        "middle_name": "DELA ROSA",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitra Felfeli
• Krista Fendrick, PA-C
• Jean M Feneis, O.D.
• Jack C Feng, M.D.
• Angela Fernandez
• Dylan Fernandez, DMD
• Jared Fernandez, ACSW, PPSC
• Rowena C. Fernandez, LCSW
• Joseph James Ferris, RPH
• Justin John Fesler, DPT

• General Practice Dentistry in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.