Vivian Villasenor, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

108095 Issued in CA

Practice address

6445 Pats Ranch Rd
Jurupa Valley, CA 91752-4439

Phone

(951) 808-5881

NPI assigned

Oct 5, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1124743851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13632 HUNTERS RUN CT",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928805500",
            "telephone_number": "626-423-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6445 PATS RANCH RD",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "917524439",
            "telephone_number": "951-808-5881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLASENOR",
        "first_name": "VIVIAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "108095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "vivian.villasenor@pacden.com",
            "affiliation": "N",
            "endpointDescription": "Pacific Dental Services email",
            "address_1": "6445 Pats Ranch Rd",
            "city": "Jurupa Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917524439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Naomi Velasco
• Daisy Velazco
• Rosa Maria Vielmas
• Jacqueline Villalta
• Janely Villanueva
• Esmeralda Villegas
• Volta Medical Group
• Katherine Wallen, OTR/L
• James Bernard Wandrie
• We Connect Transport LLC

• General Practice Dentistry in Jurupa Valley, CA
• Providers in Jurupa Valley, 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 Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.