Individual provider Active NPI

Cesar Jimenez, DDS

  • General Practice Dentistry
  • El Cajon, CA
National Provider Identifier
1205991577
Registry record updated Nov 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43980 Issued in CA
Practice address
1209 E Main St
El Cajon, CA 92021-7245
Phone
(619) 442-0707
Fax
(619) 442-4931
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2009

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 43980 CA Primary

Addresses

Primary practice location

1209 E Main St
El Cajon, CA 92021-7245

Mailing address

1209 E Main St
El Cajon, CA 92021-7245
Phone (619) 442-0707

Other identifiers 1

IdentifierTypeStateIssuer
D43980OtherCAMEDI-CAL DENTAL PROGRAM

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
I20160218001595 CA Order and Referring Only - DentistPractitioner - Dentist 1850696428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cesar Jimenez DDS Inc. General Practice Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257120000000",
    "number": "1205991577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 E MAIN ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920217245",
            "telephone_number": "619-442-0707",
            "fax_number": "619-442-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 E MAIN ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920217245",
            "telephone_number": "619-442-0707",
            "fax_number": "619-442-4931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "CESAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2009-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL DENTAL PROGRAM",
            "identifier": "D43980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

Verify at the official NPI Registry.