NPIMap

Organization Active NPI

Trujillo, DDS, a Professional Dental Corporation

  • Periodontics
  • Merced, CA
National Provider Identifier
1730434408
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
58761 Issued in CA
Legal business name
TRUJILLO, DDS, A PROFESSIONAL DENTAL CORPORATION
Practice address
3061 College Green Dr
Suite D
Merced, CA 95348-3203
Phone
(209) 383-3816
NPI assigned
Jul 19, 2012
Last updated
Jul 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Authorized official

Name
Dr. Israel J Trujillo, DDSNPI 1801104385
Title
President
Phone
(310) 966-0954

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
Periodontics 1223P0300X 58761 CA Primary

Addresses

Primary practice location

3061 College Green Dr
Suite D
Merced, CA 95348-3203

Mailing address

3061 College Green Dr
Suite D
Merced, CA 95348-3203
Phone (209) 383-3816

National Provider Directory

National Provider Directory

Locations

3061 College Green Dr
Ste D
Merced, CA 95348
Phone (209) 383-3816

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": "1342656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342656000000",
    "number": "1730434408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3061 COLLEGE GREEN DR",
            "address_2": "SUITE D",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953483203",
            "telephone_number": "209-383-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3061 COLLEGE GREEN DR",
            "address_2": "SUITE D",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953483203",
            "telephone_number": "209-383-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUJILLO, DDS, A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-07-19",
        "status": "A",
        "authorized_official_last_name": "TRUJILLO",
        "authorized_official_first_name": "ISRAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-966-0954",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "58761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.