Individual provider Active NPI

Raymond Dela Pena Ramos, D.M.D.

  • General Practice Dentistry
  • Fairfield, CA
National Provider Identifier
1740311869
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42215 Issued in CA
Practice address
2440 N Texas St
Fairfield, CA 94533-1602
Phone
(707) 422-4600
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 42215 CA Primary

Addresses

Primary practice location

2440 N Texas St
Fairfield, CA 94533-1602

Mailing address

273 Breezewalk Dr
Vallejo, CA 94591-7145
Phone (707) 315-8965

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250620001826 TX Practitioner - Dentist 2466964036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1300 National Dr
Suite 135
Sacramento, CA 95834-1947

PO Box
Suite 769
Redway, CA 95560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
42215CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Valley Indian Health Inc Current Accepting new patients
Redwoods Rural Health Center Inc. CurrentSince Sep 16, 2025 Accepting new patients
Northern Valley Indian Health, Inc CurrentSince Jun 23, 2025 Accepting new patients
Northern Valley Indian Health Inc CurrentSince Jun 23, 2025 Accepting new patients
Western Dental Services, Inc. General Practice Past Accepting new patients

Locations

207 N Butte St
Willows, CA 95988
Phone (530) 934-4641

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDAEBD

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1740311869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 BREEZEWALK DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945917145",
            "telephone_number": "707-315-8965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 N TEXAS ST",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945331602",
            "telephone_number": "707-422-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "RAYMOND",
        "middle_name": "DELA PENA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.