Individual provider Active NPI

Paul Entienza Villarubia, DDS

  • Dentist
  • Anaheim, CA
National Provider Identifier
1174656854
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
55505 Issued in CA
Practice address
2270 W Lincoln Ave
Suite B
Anaheim, CA 92801-6544
Phone
(714) 635-2388
Fax
(714) 635-4888
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 55505 CA Primary

Addresses

Primary practice location

2270 W Lincoln Ave
Suite B
Anaheim, CA 92801-6544

Mailing address

680 S Magnolia Ave
Anaheim, CA 92804-3318
Phone (714) 635-2388

Other identifiers 1

IdentifierTypeStateIssuer
D55505MedicaidCA

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
55505CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul E Villarubia DDS Inc Past Accepting new patients

Organizations & group practices 1

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1174656854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S MAGNOLIA AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043318",
            "telephone_number": "714-635-2388",
            "fax_number": "714-635-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 W LINCOLN AVE",
            "address_2": "SUITE B",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928016544",
            "telephone_number": "714-635-2388",
            "fax_number": "714-635-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARUBIA",
        "first_name": "PAUL",
        "middle_name": "ENTIENZA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "55505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D55505",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.