Individual provider Active NPI

Lymari Jamilette De la Riva Vargas

  • General Practice Dentistry
  • Chula Vista, CA
National Provider Identifier
1124843271
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
107382 Issued in CA
Practice address
1072 3Rd Ave Ste a
Chula Vista, CA 91911-2085
Phone
(619) 425-5323
NPI assigned
Nov 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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 107382 CA Primary

Addresses

Primary practice location

1072 3Rd Ave Ste a
Chula Vista, CA 91911-2085

Mailing address

9902 Jamacha Blvd SPC 23
Spring Valley, CA 91977-8023
Phone (619) 463-0921

Other practice location 1

345 F St
Chula Vista, CA 91910-2626
Phone (619) 249-3829

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
107382CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Aileen Laban Arce Dental Corporation General Practice CurrentSince Nov 24, 2024 Accepting new patients
Maria Guadalupe Estrada-Guevara DDS,Inc. PastSince Nov 24, 2024 Accepting new patients

Locations

1072 Third Ave
Ste A
Chula Vista, CA 91911
Phone (619) 425-5323

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1124843271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9902 JAMACHA BLVD SPC 23",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919778023",
            "telephone_number": "619-463-0921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 3RD AVE STE A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919112085",
            "telephone_number": "619-425-5323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 F St",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919102626",
            "country_code": "US",
            "telephone_number": "619-249-3829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA RIVA VARGAS",
        "first_name": "LYMARI",
        "middle_name": "JAMILETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.