Healthcare Provider Details

I. General information

NPI: 1821660077
Provider Name (Legal Business Name): SERGIO JUCA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2021
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1293 CARLSBAD VILLAGE DR
CARLSBAD CA
92008-1950
US

IV. Provider business mailing address

4909 TIVERTON CT
ROCKLIN CA
95677-4485
US

V. Phone/Fax

Practice location:
  • Phone: 760-274-0310
  • Fax:
Mailing address:
  • Phone: 760-730-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number106592
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: