Active NPI
Israel Jedidiah Trujillo, DDS
- Periodontics
- Merced, CA
National Provider Identifier
1801104385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 58761
- Practice address
- 850 W Olive Ave
Suite D
Merced, CA 95348-2427 - Phone
- (209) 383-3816
- Fax
- (209) 383-3817
- NPI assigned
- Sep 19, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 58761 | CA | Primary |
Addresses
Primary practice location
850 W Olive Ave
Suite D
Merced, CA 95348-2427
Mailing address
850 W Olive Ave
Suite D
Merced, CA 95348-2427
Phone (209) 383-3816
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 17, 2021 through Dec 17, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58761 | CA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trujillo, DDS, a Professional Dental Corporation | Periodontics | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Periodontics
- Merced, CA
- NPI 1730434408
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755129600000",
"number": "1801104385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 W OLIVE AVE",
"address_2": "SUITE D",
"city": "MERCED",
"state": "CA",
"postal_code": "953482427",
"telephone_number": "209-383-3816",
"fax_number": "209-383-3817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 W OLIVE AVE",
"address_2": "SUITE D",
"city": "MERCED",
"state": "CA",
"postal_code": "953482427",
"telephone_number": "209-383-3816",
"fax_number": "209-383-3817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUJILLO",
"first_name": "ISRAEL",
"middle_name": "JEDIDIAH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-19",
"last_updated": "2025-08-14",
"status": "A"
},
"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 Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.