Raul D Perez, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61046 Issued in CA

Practice address

1163 W Grand Ave
Grover Beach, CA 93433-2149

Phone

(805) 904-6979

Fax

(805) 904-6989

NPI assigned

Dec 16, 2011

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Raul D Perez DDS, Inc.

  dba WhiteCrest - Smart Dentistry

  • Dental Clinic/Center
  • Grover Beach, CA
  • NPI 1760903678
  NPD (past) Authorized official

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1407125651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 CALLE CIELO",
            "city": "NIPOMO",
            "state": "CA",
            "postal_code": "934449593",
            "telephone_number": "530-776-7231",
            "fax_number": "805-904-6989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1163 W GRAND AVE",
            "city": "GROVER BEACH",
            "state": "CA",
            "postal_code": "934332149",
            "telephone_number": "805-904-6979",
            "fax_number": "805-904-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "RAUL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-16",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley Paton, M.S. OTR/L
• James Holm Pearce, MFT
• Beliza Perdomo, LMFT
• Daniela Perez, DDS
• Destiny Perez
• Jamie Peterson, RN
• Kathryn M Phelan, DOCTOR OF CHIROPRACT
• Phyllis Borgardt & Assc., Inc. (Mobility Therapy)
• Playpath Therapy
• Naomie Plyler

• General Practice Dentistry in Grover Beach, CA
• Providers in Grover Beach, 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 26, 2016; 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.