Victor Eduardo Perez, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DDS65183 Issued in CA

Practice address

10630 Town Center Dr Ste 125
Rancho Cucamonga, CA 91730-6889

Phone

(909) 483-3131

NPI assigned

Sep 30, 2015

Last updated

Feb 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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

Locations

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.

• Ideal Dental PLLC

  • General Practice Dentistry
  • Denver, CO
  • NPI 1821533183
  Authorized official Same address or phone
• Affrunti Kunihira Dental Partnership

  dba Town Center Periodontal and Implant Specialists

  • Periodontics
  • Rancho Cucamonga, CA
  • NPI 1063172872
  NPD
• Apple Valley Periodontal Associates

  • Periodontics
  • Apple Valley, CA
  • NPI 1609536416
  NPD
• Down to Earth Dentistry, LLC.

  dba Dental Depot

  • General Practice Dentistry
  • La Junta, CO
  • NPI 1730506809
  NPD (past)
• Salt Lake Modern Dentistry, LLP

  • General Practice Dentistry
  • Salt Lake City, UT
  • NPI 1730647330
  NPD (past)

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1760852917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22108 SCHOOLCRAFT ST",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913032346",
            "telephone_number": "818-261-2514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10630 TOWN CENTER DR STE 125",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306889",
            "telephone_number": "909-483-3131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1028 E 2100 S Ste 3",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841062680",
            "country_code": "US",
            "telephone_number": "801-438-6355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "VICTOR",
        "middle_name": "EDUARDO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-30",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00202682",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "UT",
            "license": "13661508-9926",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "DDS65183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Grace R Perez, OTR/L
• Mia Perez
• Priscilla Perez
• Samantha Renee Perez
• Vanessa Perez
• Yadira Perez
• Performance Medical Management, Inc (The Performance Center)
• Cristina Perillo, DPT
• Isabel Perodeau
• Perpetual Ventures. LLC (Home Instead)

• Periodontics in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.