Active NPI
Jesusa Beatriz Perez Kelly, D.M.D.
- Dentist
- Spring Valley, CA
National Provider Identifier
1588853352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 54271
- Practice address
- 8788 Jamacha Rd
Spring Valley, CA 91977-4035 - Phone
- (619) 515-2555
- NPI assigned
- Oct 17, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 54271 | CA | Primary |
Addresses
Primary practice location
8788 Jamacha Rd
Spring Valley, CA 91977-4035
Mailing address
PO Box 262202
San Diego, CA 92196-2202
Phone (858) 622-0085
Other practice location 1
3544 30th St
San Diego, CA 92104-4120
Phone (619) 515-2434
Other practice location 2
7876 Avenida Navidad
#179
San Diego, CA 92122
Phone (858) 622-0085
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 |
|---|---|---|---|
| 54271 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1588853352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 262202",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921962202",
"telephone_number": "858-622-0085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8788 JAMACHA RD",
"city": "SPRING VALLEY",
"state": "CA",
"postal_code": "919774035",
"telephone_number": "619-515-2555"
}
],
"practiceLocations": [
{
"address_1": "3544 30th St",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921044120",
"country_code": "US",
"telephone_number": "619-515-2434",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7876 Avenida Navidad",
"address_2": "#179",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "92122",
"country_code": "US",
"telephone_number": "858-622-0085",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KELLY",
"first_name": "JESUSA",
"middle_name": "BEATRIZ PEREZ",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-17",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "54271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.