Individual provider Active NPI

Hector A. Caballero, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • La Jolla, CA
National Provider Identifier
1366585515
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
43427 Issued in CA
Practice address
9859 Genesee Ave
Suite 720
La Jolla, CA 92037-1218
Phone
(858) 336-2535
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 43427 CA Primary

Addresses

Primary practice location

9859 Genesee Ave
Suite 720
La Jolla, CA 92037-1218

Mailing address

13816 Mira Montana Dr
Del Mar, CA 92014-3112
Phone (858) 752-1089

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
I20161021001047 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0446538722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1366585515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13816 MIRA MONTANA DR",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920143112",
            "telephone_number": "858-752-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9859 GENESEE AVE",
            "address_2": "SUITE 720",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371218",
            "telephone_number": "858-336-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABALLERO",
        "first_name": "HECTOR",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "43427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.