Individual provider Active NPI

Bastian Andres Rojas Espinoza, DDS

  • Prosthodontics
  • Bloomington, IL
National Provider Identifier
1780292680
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
D00146 Issued in KY
Practice address
1507 N Veterans Pkwy Ste 1
Bloomington, IL 61704-0916
Phone
(309) 664-6666
NPI assigned
Jul 16, 2020
Last updated
Jun 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.033929 IL
Prosthodontics 1223P0700X D00146 KY Primary
Student in an Organized Health Care Education/Training Program 390200000X 12836 CT

Addresses

Primary practice location

1507 N Veterans Pkwy Ste 1
Bloomington, IL 61704-0916

Mailing address

1507 N Veterans Pkwy Ste 1
Bloomington, IL 61704-0916
Phone (309) 664-6666

Other practice location 1

800 Rose St
Lexington, KY 40536-0297
Phone (859) 323-3368

Other practice location 2

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brojasexpinoza38221@direct.med.uchc.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20200820001987 CT Order and Referring Only - DentistPractitioner - Dentist 1456777499

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.033929ILMDGeneral Practice Dentistry
D00146KYMDProsthodontist

Interoperability endpoints

  • Direct secure messaging: brojasexpinoza38221@direct.med.uchc.edu

NPI Registry JSON

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1780292680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 N VETERANS PKWY STE 1",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617040916",
            "telephone_number": "309-664-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 N VETERANS PKWY STE 1",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617040916",
            "telephone_number": "309-664-6666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Rose St",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360297",
            "country_code": "US",
            "telephone_number": "859-323-3368",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060300001",
            "country_code": "US",
            "telephone_number": "860-679-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROJAS ESPINOZA",
        "first_name": "BASTIAN",
        "middle_name": "ANDRES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-16",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.033929",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "KY",
            "license": "D00146",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": "12836",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brojasexpinoza38221@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "263 Farmington Ave",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060300001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.