Active NPI
Juan Antonio T Trejo Canchola, DDS
- General Practice Dentistry
- Anaheim, CA
National Provider Identifier
1528336906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 61049
- Practice address
- 624 S Euclid St
Anaheim, CA 92802-1234 - Phone
- (714) 774-3000
- NPI assigned
- Dec 13, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 61049 | CA | Primary |
Addresses
Primary practice location
624 S Euclid St
Anaheim, CA 92802-1234
Mailing address
624 S Euclid St
Anaheim, CA 92802-1234
Phone (951) 842-0803
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61049 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ayala Arizmendi Dental Corporation | Past | Accepting new patients | |
| Ayala Arizmendi Dental Corporation | General Practice | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Practice Dentistry
- Anaheim, CA
- NPI 1093266785
-
- Dentist
- Anaheim, CA
- NPI 1568716603
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372550400000",
"number": "1528336906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "624 S EUCLID ST",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928021234",
"telephone_number": "951-842-0803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "624 S EUCLID ST",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928021234",
"telephone_number": "714-774-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TREJO CANCHOLA",
"first_name": "JUAN ANTONIO",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-13",
"last_updated": "2013-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "61049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.