Ruben Jesus Villa, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

102237 Issued in CA

Practice address

95 W 11TH St Ste 202
Tracy, CA 95376-3961

Phone

(209) 229-8108

Fax

(209) 221-0883

NPI assigned

Jan 4, 2018

Sex

Male

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ruben Jesus Villa DDS,Inc

  • Dental Clinic/Center
  • Tracy, CA
  • NPI 1528794815
  NPD Authorized official

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1427565118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 LARKSPUR DR",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953769782",
            "telephone_number": "209-830-8344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 W 11TH ST STE 202",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763961",
            "telephone_number": "209-229-8108",
            "fax_number": "209-221-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA",
        "first_name": "RUBEN",
        "middle_name": "JESUS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-04",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "102237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Marie Vicente
• Fay Gladys Vieira
• Jessica Vieira
• Michelle Villa Molina
• Erica Villa
• Mateo Villalobos
• Jazmine Villanueva Barraza
• Loribel Villar
• Emil Guansing Villaroman Jr.
• Melissa Alvis Villaroman, DDS

• Dentist in Tracy, CA
• Providers in Tracy, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.