Individual provider Active NPI

Antonio Estrada, DDS

  • General Practice Dentistry
  • El Centro, CA
National Provider Identifier
1306631288
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4327836 Issued in ZZ
Practice address
720 Desert Gardens Dr
El Centro, CA 92243-4416
Phone
(619) 831-0437
Fax
(619) 785-3404
NPI assigned
Apr 11, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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 4327836 ZZ Primary

Addresses

Primary practice location

720 Desert Gardens Dr
El Centro, CA 92243-4416

Mailing address

3554 Sunset LN Unit 32
San Ysidro, CA 92173-4506
Phone (619) 831-0437

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
4327836ZZMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1744329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1306631288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3554 SUNSET LN UNIT 32",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921734506",
            "telephone_number": "619-831-0437",
            "fax_number": "619-785-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 DESERT GARDENS DR",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434416",
            "telephone_number": "619-831-0437",
            "fax_number": "619-785-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "ANTONIO",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-11",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ZZ",
            "license": "4327836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.