Mario Herrejon-Ruiz, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

010475 Issued in AZ

Practice address

4935 S Val Vista Dr Ste 104
Gilbert, AZ 85298-0757

Phone

(480) 482-7773

Fax

(480) 482-7774

NPI assigned

Jul 24, 2009

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 NM

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.

• Satelite Co LLC

  • General Practice Dentistry
  • Gilbert, AZ
  • NPI 1174414841
  NPD Authorized official
• Las Tiendas Dental Group, LLP

  • General Practice Dentistry
  • Chandler, AZ
  • NPI 1609962760
  NPD (past)

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1639309594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4935 S VAL VISTA DR STE 104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852980757",
            "telephone_number": "480-482-7773",
            "fax_number": "480-482-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4935 S VAL VISTA DR STE 104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852980757",
            "telephone_number": "480-482-7773",
            "fax_number": "480-482-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERREJON-RUIZ",
        "first_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-24",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "010475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Hernandez
• Stephanie M. Hernandez
• Vincent Robert Hernandez, PAC
• Heron Care LLC
• Bruce L. Herr Jr., D.D.S.
• Guadalupe Herrera-Garcia, D.O.
• Ingrid Herrera
• Jessica Herrera, RBT
• Breana Herriford
• Kathryn E. Herron

• Dentist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.