NPIMap

Organization Active NPI

Julio E Caceres DDS, Inc

  • Dentist
  • Corona, CA
National Provider Identifier
1609333673
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
JULIO E CACERES DDS, INC
Practice address
80 W Grand Blvd Ste 111
Corona, CA 92882-2059
Phone
(951) 549-1111
Fax
(951) 549-1190
NPI assigned
Feb 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Julio E Caceres, DDS
Title
Owner
Phone
(951) 549-1111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X

Addresses

Primary practice location

80 W Grand Blvd Ste 111
Corona, CA 92882-2059

Mailing address

80 W Grand Blvd Ste 111
Corona, CA 92882-2059
Phone (951) 549-1111

Other identifiers 1

IdentifierTypeStateIssuer
DDS49850OtherCADENTAL LICENSE

National Provider Directory

National Provider Directory

Locations

80 W Grand Blvd
Ste 111
Corona, CA 92882
Phone (951) 549-1111

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1609333673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 W GRAND BLVD STE 111",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822059",
            "telephone_number": "951-549-1111",
            "fax_number": "951-549-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 W GRAND BLVD STE 111",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822059",
            "telephone_number": "951-549-1111",
            "fax_number": "951-549-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIO E CACERES DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-26",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "CACERES",
        "authorized_official_first_name": "JULIO",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-549-1111",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DDS49850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.