Organization Active NPI

J Acuna Loera Dental Corporation Inc

  • Dentist
  • Spring Valley, CA
National Provider Identifier
1629518691
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
48320 Issued in CA
Legal business name
J ACUNA LOERA DENTAL CORPORATION INC
Practice address
8300 Paradise Valley Rd Ste 122
Spring Valley, CA 91977-6214
Phone
(619) 479-9143
NPI assigned
Feb 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Authorized official

Name
Dr. Jaime Acuna Loera, DDSNPI 1588723415
Title
Dentist
Phone
(619) 424-3456

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 48320 CA Primary

Addresses

Primary practice location

8300 Paradise Valley Rd Ste 122
Spring Valley, CA 91977-6214

Mailing address

8300 Paradise Valley Rd Ste 122
Spring Valley, CA 91977-6214
Phone (619) 479-9143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211018001044 CA Part B Supplier - Clinic/Group Practice 4082012323 Receives reassigned benefits from 1 practitioner
Practice locations: Spring Valley, CA

National Provider Directory

National Provider Directory

Locations

8300 Paradise Valley Rd
Ste 122
Spring Valley, CA 91977
Phone (619) 479-9143

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636070400000",
    "number": "1629518691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 PARADISE VALLEY RD STE 122",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919776214",
            "telephone_number": "619-479-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 PARADISE VALLEY RD STE 122",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919776214",
            "telephone_number": "619-479-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J ACUNA LOERA DENTAL CORPORATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-24",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A",
        "authorized_official_last_name": "ACUNA LOERA",
        "authorized_official_first_name": "JAIME",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "619-424-3456",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "48320",
            "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 Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.