MEDICARE: VIVIAN VILLASENOR DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	108095	CA

General Provider Information

NPI Number	:	1124743851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIVIAN VILLASENOR DMD

Provider Business Mailing Address
First Line	:	13632 HUNTERS RUN CT
Second Line	:
City	:	EASTVALE
State	:	CA
Zip	:	92880-5500
Country	:	US
Telephone Number	:	626-423-2800
Fax Number	:

Provider Business Practice Location Address
First Line	:	6445 PATS RANCH RD
Second Line	:
City	:	JURUPA VALLEY
State	:	CA
Zip	:	91752-4439
Country	:	US
Telephone Number	:	951-808-5881
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2022
Last Update Date	:	10/05/2022

Similar Medicare Providers

1225073588 — VALLEY ASSOCIATED UROLOGY MEDICARE GROUP INC
Practice Location Address:

200 COTTAGE AVE , STE 101
MANTECA, CA
95336-4935

Practice Phone: 209-239-2197
Practice Fax: 209-239-7672

1104029073 — DR. NORMA L ANDRONIC DDS
Practice Location Address:

6445 PATS RANCH RD STE G
JURUPA VALLEY, CA
91752-4439

Practice Phone: 951-808-5881
Practice Fax:

1972058964 — HYUN WOOK NAM D.M.D.
Practice Location Address:

6445 PATS RANCH RD STE F
JURUPA VALLEY, CA
91752-4439

Practice Phone: 951-228-9328
Practice Fax:

1548884109 — SOPHIA AZER SAWIRES DDS
Practice Location Address:

6445 PATS RANCH RD STE G
JURUPA VALLEY, CA
91752-4439

Practice Phone: 714-625-1319
Practice Fax:

1154215531 — JUSTIN DONGEON KIM DMD
Practice Location Address:

6445 PATS RANCH RD STE G
JURUPA VALLEY, CA
91752-4439

Practice Phone: 951-808-5881
Practice Fax:

1073730941 — HERBERT CHIROPRACTIC OFFICES
Practice Location Address:

3730 PONTIAC AVE
JURUPA VALLEY, CA
92509-4439

Practice Phone: 951-683-4935
Practice Fax: 951-684-1551

Directions to “ VIVIAN VILLASENOR DMD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.