Paraon Nolasc Dequiroz, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

45242 Issued in CA

Practice address

2503 Professional Pkwy
Santa Maria, CA 93455-1657

Phone

(805) 934-4500

Fax

(805) 934-5263

NPI assigned

Oct 29, 2015

Last updated

Sep 20, 2018By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Paraon N Dequiroz, DDS, PC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Santa Maria, CA
  • NPI 1548321516
  Authorized official Same address or phone
• PN Dequiroz DDS Inc

  dba Central Coast Dental Implant Center

  • Oral and Maxillofacial Surgery Clinic/Center
  • Santa Maria, CA
  • NPI 1679057186
  Authorized official Same address or phone

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1801268883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2503 PROFESSIONAL PKWY",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934551657",
            "telephone_number": "805-934-4500",
            "fax_number": "805-934-5263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2503 PROFESSIONAL PKWY",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934551657",
            "telephone_number": "805-934-4500",
            "fax_number": "805-934-5263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 W Main St",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934585035",
            "country_code": "US",
            "telephone_number": "760-815-2835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEQUIROZ",
        "first_name": "PARAON",
        "middle_name": "NOLASC",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-29",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "45242",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "DDS45242",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA DENTAL LICENSE NUMBER",
            "identifier": "DDS45242",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dennis D Shepard MD Inc
• Dennis D Shepard MD Inc (Shepard Eye Center Medical Group)
• Debora Rhen Dennis, M.A.
• Sam Densen, MD
• Dental Surgery Centers of America (Grace Surgery Center)
• Derek NG DDS Inc
• Kamlesh Mohan Desai, M.D.
• Tyrone Desaussure Sr., LPT
• Morgan Desjardins
• Brian Desmond, M.D.

• Dentist in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.