Jessica Ventenilla Raldiris, DMD, MPH

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D012432 Issued in AZ

Practice address

6422 E Speedway Blvd Ste 150
Tucson, AZ 85710-1149

Phone

(520) 326-8516

Fax

(520) 326-8516

NPI assigned

Feb 28, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

DentistAlso: Pediatric Dentistry

Education

Midwestern University College of Dental Medicine, Downers Grove, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Mariposa Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Nogales, AZ
  • NPI 1417985474
  Medicare reassignment NPD
• Mariposa Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Patagonia, AZ
  • NPI 1003837618
  NPD
• Mariposa Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Nogales, AZ
  • NPI 1487537445
  NPD

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1467151308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N GRAND AVE STE 100",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211061",
            "telephone_number": "520-375-5032",
            "fax_number": "520-761-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6422 E SPEEDWAY BLVD STE 150",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857101149",
            "telephone_number": "520-326-8516",
            "fax_number": "520-326-8516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10520 N La Canada Dr",
            "address_purpose": "LOCATION",
            "city": "Oro Valley",
            "state": "AZ",
            "postal_code": "857377010",
            "country_code": "US",
            "telephone_number": "520-326-8516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1852 N Mastick Way",
            "address_purpose": "LOCATION",
            "city": "Nogales",
            "state": "AZ",
            "postal_code": "856211063",
            "country_code": "US",
            "telephone_number": "520-761-2128",
            "fax_number": "520-761-2159",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "716 N Country Club Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857164506",
            "country_code": "US",
            "telephone_number": "520-326-8516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6422 E Speedway Blvd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857101148",
            "country_code": "US",
            "telephone_number": "520-326-8516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4566 N 1st Ave Ste 150",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857185680",
            "country_code": "US",
            "telephone_number": "520-326-8516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RALDIRIS",
        "first_name": "JESSICA",
        "middle_name": "VENTENILLA",
        "credential": "DMD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D012432",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D012432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Kate Rainsdon
• Viswanathan Rajesh, M.D
• Guruprasad Raju, MD
• Raksa Wellness
• Mittida Raksanaves, DDS, MS
• Trenton Raley
• Raley'S Arizona LLC
• Raley'S Arizona LLC
• Raley'S Arizona LLC
• Raley'S Arizona LLC

• Pediatric Dentistry in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Pediatric Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.