Jorge Hernandez-Zamudio, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45873 Issued in CA

Practice address

1410 3Rd St Ste 4
Riverside, CA 92507-3454

Phone

(951) 263-6488

Fax

(951) 686-8783

NPI assigned

Mar 7, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jorge H. Zamudio DDS Inc.

  • Dentist
  • Riverside, CA
  • NPI 1265962773

  General Practice

  NPD Authorized official

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289174400000",
    "number": "1609906403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 3RD ST STE 4",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925073454",
            "telephone_number": "951-263-6488",
            "fax_number": "951-686-8783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 3RD ST STE 4",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925073454",
            "telephone_number": "951-263-6488",
            "fax_number": "951-686-8783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ-ZAMUDIO",
        "first_name": "JORGE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2010-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "525449",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Omar Hernandez-Cruz
• Gerson Hernandez-Esqueda
• Karla Giovanna Hernandez-Floes
• Melissa Hernandez-Gaona
• Nancy Hernandez-Mirelez
• Aaron Hernandez
• Abraham Hernandez
• Adrian Hernandez
• Alan Hernandez
• Alanna Raelyn Hernandez

• General Practice Dentistry in Riverside, CA
• Providers in Riverside, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.