Active NPI
Jemilyn Velasco
- Dental Assistant
- Santa Ana, CA
National Provider Identifier
1558787416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 58764
- Practice address
- 550 N Flower St
Santa Ana, CA 92703-2361 - Phone
- (714) 647-4148
- NPI assigned
- Mar 14, 2014
- Last updated
- Mar 15, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 58764 | CA | Primary |
Addresses
Primary practice location
550 N Flower St
Santa Ana, CA 92703-2361
Mailing address
1160 Starbright Dr
Corona, CA 92882-8338
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 |
|---|---|---|---|
| 58764 | CA | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394841600000",
"number": "1558787416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1160 STARBRIGHT DR",
"city": "CORONA",
"state": "CA",
"postal_code": "928828338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 N FLOWER ST",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927032361",
"telephone_number": "714-647-4148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELASCO",
"first_name": "JEMILYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-14",
"last_updated": "2014-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CA",
"license": "58764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.