Rolando Algozo De Jesus, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

41388 Issued in CA

Practice address

1350 W. Robinhood Dr.
Suite #4
Stockton, CA 95207-5512

Phone

(510) 676-4897

Fax

(209) 451-3154

NPI assigned

Apr 4, 2008

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bhangu Dental Corporation

  • Dental Clinic/Center
  • Stockton, CA
  • NPI 1689392482
  NPD (past)

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1326211871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 W ROBINHOOD DR",
            "address_2": "SUITE #4",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075512",
            "telephone_number": "209-451-3155",
            "fax_number": "209-451-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 W. ROBINHOOD DR.",
            "address_2": "SUITE #4",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075512",
            "telephone_number": "510-676-4897",
            "fax_number": "209-451-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "ROLANDO",
        "middle_name": "ALGOZO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-04",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL BOARD OF CALIFORNI",
            "identifier": "41388",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan Reyes De Guzman
• Paola De Guzman, M.A.
• Thomas Kevin De Guzman
• Carolyn Pascua De Jesus
• Kirsten De Jesus
• Gabriella De la Cerda
• Maria Christina De la Cruz
• Rey Gerard Adan De la Cruz, PT, DPT
• Amanda V De la Cueva
• Lucy De la Fuente Romero

• General Practice Dentistry in Stockton, CA
• Providers in Stockton, 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 Jul 5, 2012; 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.