Individual provider Active NPI

Eugenio Bedolla, D.D.S.

  • General Practice Dentistry
  • Watsonville, CA
National Provider Identifier
1417045584
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
53968 Issued in CA
Practice address
36 Aspen Way Ste B
Watsonville, CA 95076-3084
Phone
(831) 319-4344
NPI assigned
Oct 11, 2006
Last updated
Oct 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 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 53968 CA Primary

Addresses

Primary practice location

36 Aspen Way Ste B
Watsonville, CA 95076-3084

Mailing address

36 Aspen Way Ste B
Watsonville, CA 95076-3084
Phone (831) 319-4344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Univ of Calif, San Francisco School of Dentistry, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1150 Primrose Dr
Roswell, GA 30076-4217

1325 Bridge Mill Ave
Canton, GA 30114-7762

36 Aspen Way
Suite B
Watsonville, CA 95076-3084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eugenio Bedolla DDS Inc General Practice CurrentSince Jun 1, 2025 Accepting new patients
Jason L Cook DDS Inc General Practice PastSince Feb 8, 2023 Accepting new patients

Locations

36 Aspen Way
Watsonville, CA 95076
Phone (831) 728-2266

36 Aspen Way
#B
Watsonville, CA 95076
Phone (831) 319-4344

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1417045584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 ASPEN WAY STE B",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950763084",
            "telephone_number": "831-319-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 ASPEN WAY STE B",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950763084",
            "telephone_number": "831-319-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDOLLA",
        "first_name": "EUGENIO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

Verify at the official NPI Registry.