Jo Devenne Elek Sullano Bilbao, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

56034 Issued in CA

Practice address

3681 East Highland Ave
Highland, CA 92346

Phone

(909) 425-8788

NPI assigned

Oct 5, 2007

Last updated

Oct 6, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• J D E Bilbao DDS

  dba Night Owl Dental

  • General Practice Dentistry
  • Lomita, CA
  • NPI 1225448863
  Medicare reassignment NPD

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254787200000",
    "number": "1265620009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3681 EAST HIGHLAND AVE",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "92346",
            "telephone_number": "909-425-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3681 EAST HIGHLAND AVE",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "92346",
            "telephone_number": "909-425-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILBAO",
        "first_name": "JO DEVENNE ELEK",
        "middle_name": "SULLANO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-05",
        "last_updated": "2009-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Beitel, M.D.
• John Beld, DPT
• Marian N.B. Beshara, M.D.
• Lizbet Betancio
• Xiomara Betanco
• Amanda Ann Blanton
• Judy F. Blodgett, PA
• Catherine Bodman
• Amanda Bowen, MPH, RD, CDE
• Katherine Boyko, LMT

• General Practice Dentistry in Highland, CA
• Providers in Highland, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.