Ceballos Professional Dental Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CEBALLOS PROFESSIONAL DENTAL CORPORATION

Practice address

965 S Beach Blvd
Anaheim, CA 92804-3983

Phone

(714) 527-2982

NPI assigned

Sep 19, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Carla Vanessa Ceballos, DDSNPI 1427719491

Title

Dentist /0Wner

Phone

(914) 268-1016

Specialties & licenses 1

Addresses

Other names 1

• Rocedent Family Dental Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carla Vanessa Ceballos

  • Dentist
  • Fullerton, CA
  • NPI 1427719491
  NPD Authorized official

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1194503243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 S BEACH BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043983",
            "telephone_number": "714-527-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 S BEACH BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043983",
            "telephone_number": "714-527-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEBALLOS PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "CEBALLOS",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "VANESSA",
        "authorized_official_title_or_position": "DENTIST /0WNER",
        "authorized_official_telephone_number": "914-268-1016",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rocedent Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nadine Cazares
• Cbas Healthcare Group, Inc.
• CCC Surgery Center LLC
• Cccri Inc
• Cccri Inc
• Alejandra Ceballos- Martinez, BA
• Itzel Ceballos
• Jozalyn Ceballos
• Cedars Home Health Care Inc
• Cedars-Sinai Medical Care Foundation

• Dental Clinic/Center in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.