Villalta Dental Corporation

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

VILLALTA DENTAL CORPORATION

Practice address

12555 W Jefferson Blvd Ste 210
Los Angeles, CA 90066-7032

Phone

(707) 228-5974

NPI assigned

Dec 27, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Y Villalta, DDS, MPHNPI 1952841389

Title

Pediatric Dentist, Owner

Phone

(707) 228-5974

Specialties & licenses 1

Addresses

Other names 1

• The Baby Teeth Studio Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Villalta, DDS, MPH

  • Pediatric Dentistry
  • Los Angeles, CA
  • NPI 1952841389
  NPD Authorized official

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672099200000",
    "number": "1982317657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12555 W JEFFERSON BLVD STE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900667032",
            "telephone_number": "707-228-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12555 W JEFFERSON BLVD STE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900667032",
            "telephone_number": "707-228-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLALTA DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "VILLALTA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST, OWNER",
        "authorized_official_telephone_number": "707-228-5974",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MPH"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Baby Teeth Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Citlali Marie Villalpando
• Cristina Villalpando, MD
• Emmanuel Villalpando
• Maximiano Villalpando, NP
• Yolanda Cudid Villalpando
• Darlene Villalta
• Edgar Villalta
• Gabriela Villalta
• Jennifer Villalta, DDS, MPH
• Joshua Villalta

• Pediatric Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.