Individual provider Active NPI

Sally Esquivel, D.D.S.

  • Dentist
  • Upland, CA
National Provider Identifier
1134499551
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50054 Issued in CA
Practice address
270 E 7TH St
Suite 2B
Upland, CA 91786-6602
Phone
(909) 985-1211
Fax
(909) 982-8482
NPI assigned
Jan 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 50054 CA Primary

Addresses

Primary practice location

270 E 7TH St
Suite 2B
Upland, CA 91786-6602

Mailing address

270 E 7TH St
Suite 2B
Upland, CA 91786-6602
Phone (909) 985-1211

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160607000779 CA Order and Referring Only - DentistPractitioner - Dentist 8628368487

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Esquivel D.D.S. Dental Corporation Current Accepting new patients
Esquivel Dental Corporation Past Accepting new patients
Jerson Vasquez DDS Inc. Past Accepting new patients

Organizations & group practices 3

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": "1325462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1134499551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 E 7TH ST",
            "address_2": "SUITE 2B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917866602",
            "telephone_number": "909-985-1211",
            "fax_number": "909-982-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 E 7TH ST",
            "address_2": "SUITE 2B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917866602",
            "telephone_number": "909-985-1211",
            "fax_number": "909-982-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESQUIVEL",
        "first_name": "SALLY",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-02",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.