Individual provider Active NPI

Yessenia Valverde Ingersoll, DMD

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1831703800
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
105181 Issued in CA
Practice address
7011 Linda Vista Rd
San Diego, CA 92111-6307
Phone
(858) 810-8729
NPI assigned
Sep 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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 105181 CA Primary

Addresses

Primary practice location

7011 Linda Vista Rd
San Diego, CA 92111-6307

Mailing address

7011 Linda Vista Rd
San Diego, CA 92111-6307
Phone (858) 810-8729

Other names 1

  • Yessenia Valverde Guevara Former 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
I20210128002115 CA Order and Referring Only - DentistPractitioner - Dentist 1759795990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1831703800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7011 LINDA VISTA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921116307",
            "telephone_number": "858-810-8729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 LINDA VISTA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921116307",
            "telephone_number": "858-810-8729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALVERDE INGERSOLL",
        "first_name": "YESSENIA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-07",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YESSENIA",
            "last_name": "VALVERDE GUEVARA",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.