Juan Ivan Ruvalcaba Vazquez, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

109349 Issued in CA

Practice address

827 S Akers St Ste 104
Visalia, CA 93277-9562

Phone

(559) 732-1953

NPI assigned

Sep 11, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

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.

• Fareid Dental Corporation

  • General Practice Dentistry
  • Visalia, CA
  • NPI 1265839831
  NPD (past)

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1629855812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4129 S MOONEY BLVD STE B",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932779147",
            "telephone_number": "559-732-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 S AKERS ST STE 104",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932779562",
            "telephone_number": "559-732-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUVALCABA VAZQUEZ",
        "first_name": "JUAN",
        "middle_name": "IVAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Rupp
• Heather Russell
• Laura Teresa Russo Herrera, MD
• Emma Angela Ruth
• Karrin Nicole Rutledge, MD
• Patricia Nicole Ryan
• Rachal C Ryan
• Nicole Rymer, MS
• Stanislav Ryndin
• S. Oh Dental Corp

• Dentist in Visalia, CA
• Providers in Visalia, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.