Individual provider Active NPI

Vince Ellis Villamor Olanda, DDS

  • General Practice Dentistry
  • Modesto, CA
National Provider Identifier
1801716204
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
112370 Issued in CA
Practice address
1006 H St Ste 2
Modesto, CA 95354-2384
Phone
(209) 338-3388
NPI assigned
Jul 16, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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 112370 CA Primary

Addresses

Primary practice location

1006 H St Ste 2
Modesto, CA 95354-2384

Mailing address

8522 Vine LN
Tracy, CA 95304-8117
Phone (707) 718-4624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1784160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1801716204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8522 VINE LN",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953048117",
            "telephone_number": "707-718-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 H ST STE 2",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953542384",
            "telephone_number": "209-338-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLANDA",
        "first_name": "VINCE ELLIS",
        "middle_name": "VILLAMOR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-16",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "112370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; 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.