Raul J Vallejo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

37376 Issued in CA

Practice address

11301 Atlantic Ave
Lynwood, CA 90262-3007

Phone

(310) 603-1383

NPI assigned

Jun 12, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Raul J. Vallejo D. D. S., Inc.

  dba Atlantic Dental Office

  • Point of Service
  • Lynwood, CA
  • NPI 1699120683
  NPD (past) Authorized official

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649474891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 ATLANTIC AVE",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623007",
            "telephone_number": "310-603-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 ATLANTIC AVE",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623007",
            "telephone_number": "310-603-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEJO",
        "first_name": "RAUL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mildred Urrutia
• Kimberly Vail
• Bill Alexis Valdez Cifuentes
• Adam Valdivia
• Denise Marguerite Valdivia
• Marlene Vance Jaffe, MSW,LCSW
• Sai Prashanthi Varakala
• Veronica Vargas, STUDENT
• Vascular & Thoracic Associates of Los Angeles
• Claire Anne Vasquez

• General Practice Dentistry in Lynwood, CA
• Providers in Lynwood, 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 Jul 8, 2007; 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.