Individual provider Active NPI

Ralph Luna Raya, D.D.S.

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1922043892
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29728 Issued in CA
Practice address
10715 Tierrasanta Blvd Ste C
San Diego, CA 92124-2610
Phone
(858) 278-6444
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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 29728 CA Primary

Addresses

Primary practice location

10715 Tierrasanta Blvd Ste C
San Diego, CA 92124-2610

Mailing address

10715 Tierrasanta Blvd
Suite C
San Diego, CA 92124-2610
Phone (858) 278-6444

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
I20171012003436 CA Order and Referring Only - DentistPractitioner - Dentist 0345515540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29728CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1922043892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10715 TIERRASANTA BLVD",
            "address_2": "SUITE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921242610",
            "telephone_number": "858-278-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10715 TIERRASANTA BLVD STE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921242610",
            "telephone_number": "858-278-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYA",
        "first_name": "RALPH",
        "middle_name": "LUNA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.