Individual provider Active NPI

Dominique Solis Mancilla

  • General Practice Dentistry
  • Murrieta, CA
National Provider Identifier
1518844794
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
112234 Issued in CA
Practice address
40484 Murrieta Hot Springs Rd Ste 102
Murrieta, CA 92563-6437
Phone
(951) 461-4306
NPI assigned
Aug 19, 2025
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 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 112234 CA Primary

Addresses

Primary practice location

40484 Murrieta Hot Springs Rd Ste 102
Murrieta, CA 92563-6437

Mailing address

30225 Via Palermo
Menifee, CA 92584-8151
Phone (747) 272-6761

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson and Lee Dental Corporation General Practice PastSince Aug 25, 2025 Accepting new patients

Organizations & group practices 1

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": "1755561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1518844794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30225 VIA PALERMO",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925848151",
            "telephone_number": "747-272-6761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40484 MURRIETA HOT SPRINGS RD STE 102",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925636437",
            "telephone_number": "951-461-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLIS MANCILLA",
        "first_name": "DOMINIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "112234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.