Juan Carlos Villalobos, MDM

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

10832 Issued in KY

Practice address

501 S Preston St
Louisville, KY 40202-1701

Phone

(502) 852-7903

NPI assigned

Jan 13, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1255045225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 RIVER SHORE DR APT 402",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402062795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S PRESTON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021701",
            "telephone_number": "502-852-7903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALOBOS",
        "first_name": "JUAN CARLOS",
        "credential": "MDM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "10832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE KENTUCKY BOARD OF DENTISTRY",
            "identifier": "10832",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "louisville.edu",
            "affiliation": "N",
            "endpointDescription": "School of Dentistry",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "501 S Preston St",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ricardo L Vidal Gonzalez
• Navjyot Kaur Vidwan, M.D.
• Viemed Clinical Services, LLC
• Jeanne Viers, APRN
• Juan Villafane, M.D.
• Villalon Dental PLLC
• Wayne Garcia Villanueva, M.D.
• Maria Elena Villaran
• Priscilla A Villaroman, M.D.
• Tara Villars, B.A.

• Pediatric Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• Pediatric Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.