Individual provider Active NPI

Juan Carlos Romero, D.D.S.

  • General Practice Dentistry
  • Sun City, CA
National Provider Identifier
1790865491
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42767 Issued in CA
Practice address
27830 Bradley Rd
Sun City, CA 92586-2239
Phone
(951) 679-5313
Fax
(951) 679-6344
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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 42767 CA Primary

Addresses

Primary practice location

27830 Bradley Rd
Sun City, CA 92586-2239

Mailing address

27830 Bradley Rd
Sun City, CA 92586-2239
Phone (951) 679-5313

Other names 1

  • Dr. J. C. Romero Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150709001013 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5092027789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405641600000",
    "number": "1790865491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27830 BRADLEY RD",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925862239",
            "telephone_number": "951-679-5313",
            "fax_number": "951-679-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27830 BRADLEY RD",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925862239",
            "telephone_number": "951-679-5313",
            "fax_number": "951-679-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2014-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J.",
            "last_name": "ROMERO",
            "middle_name": "C.",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Sun City, CA

Sources for this page

Verify at the official NPI Registry.