Individual provider Active NPI

Rocio D Deza, DDS

  • General Practice Dentistry
  • Moreno Valley, CA
National Provider Identifier
1982707907
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43332 Issued in CA
Practice address
23080 Alessandro Blvd
Ste 201
Moreno Valley, CA 92553-9673
Phone
(951) 697-0909
Fax
(951) 697-1116
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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 43332 CA Primary

Addresses

Primary practice location

23080 Alessandro Blvd
Ste 201
Moreno Valley, CA 92553-9673

Mailing address

18306 Berry Rd
Riverside, CA 92508-8869
Phone (951) 697-0909

Other identifiers 2

IdentifierTypeStateIssuer
G91546-01OtherCADENTI-CAL
B43332-1OtherCADELTA DENTAL HEALTHY FAMI

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Deza'S Dental Office Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1982707907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18306 BERRY RD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925088869",
            "telephone_number": "951-697-0909",
            "fax_number": "951-697-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23080 ALESSANDRO BLVD",
            "address_2": "STE 201",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925539673",
            "telephone_number": "951-697-0909",
            "fax_number": "951-697-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEZA",
        "first_name": "ROCIO",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "G91546-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL HEALTHY FAMI",
            "identifier": "B43332-1",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.