Jorge L. Geronimo, DDS Prof. Dental Corp.
NPI 1265809065ActiveOrganization· Preferred Provider Organization· Riverside, CA
Preferred Provider Organization in Riverside, California, registered in NPPES in August 2015, part of Pacific Dental Clinic. The authorized official on file is Jorge Luis Geronimo, DDS, Dentist.
Overview
| NPI | 1265809065 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Pacific Dental Clinic |
| NPI issued | Aug 27, 2015 |
| Last updated in NPPES | Jan 3, 2020 |
| Certified by provider | Jan 3, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Preferred Provider Organization Primary | 305R00000X | 47897 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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