Patricia Campillo Peralta

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DDS103440 Issued in CA

Practice address

8590 Rio San Diego Dr Ste 110
San Diego, CA 92108

Phone

(619) 299-1122

NPI assigned

Dec 15, 2014

Last updated

Jul 15, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Kimball Dental Group of Mission Valley, PC

  dba Rio Vista Family Dentistry

  • Dentist
  • San Diego, CA
  • NPI 1073164141
  NPD

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1801294301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 APERTURE CIR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8590 RIO SAN DIEGO DR STE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92108",
            "telephone_number": "619-299-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPILLO PERALTA",
        "first_name": "PATRICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-15",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS040113",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "DDS103440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer F Campenot, MD
• Caitland Camper
• Cheyenne Camper
• Jocelyne Campese
• Andrea Campian, DPT
• Michelle Denise Campillo-Peters, PTA
• Richard Christopher Campin, M.D.
• Christie Kay Campla, MD, PHD
• Jacob Campman
• Maria Campman, R.N

• Orthodontics and Dentofacial Orthopedics Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; 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.