Individual provider Active NPI

Wendy Priscilla Rojas Acuna, DDS

  • General Practice Dentistry
  • Tulare, CA
National Provider Identifier
1487163713
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
102136 Issued in CA
Practice address
1201 N Cherry St
Tulare, CA 93274-2233
Phone
(559) 686-9097
Fax
(559) 366-7060
NPI assigned
Sep 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 60737390 WA
General Practice Dentistry 1223G0001X 102136 CA Primary

Addresses

Primary practice location

1201 N Cherry St
Tulare, CA 93274-2233

Mailing address

1201 N Cherry St
Tulare, CA 93274-2233
Phone (559) 686-9097

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
I20171129002365 CA Order and Referring Only - DentistPractitioner - Dentist 5395002398

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60737390WAMDDentist
102136CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1487163713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 N CHERRY ST",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932742233",
            "telephone_number": "559-686-9097",
            "fax_number": "559-366-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N CHERRY ST",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932742233",
            "telephone_number": "559-686-9097",
            "fax_number": "559-366-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROJAS ACUNA",
        "first_name": "WENDY",
        "middle_name": "PRISCILLA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-29",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "60737390",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulare, CA

Sources for this page

Verify at the official NPI Registry.