Individual provider Active NPI

Diana Carolina Reyes, D.D.S

  • General Practice Dentistry
  • Katy, TX
National Provider Identifier
1083066260
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31970 Issued in TX
Practice address
2731 FM 1463 Rd
Suite 500
Katy, TX 77494-3828
Phone
(281) 712-6980
NPI assigned
Jul 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 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 31970 TX Primary

Addresses

Primary practice location

2731 FM 1463 Rd
Suite 500
Katy, TX 77494-3828

Mailing address

2731 FM 1463 Rd
Suite 500
Katy, TX 77494-3828
Phone (281) 712-6980

Other names 1

  • Diana Carolina Perez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170428002046 TX Order and Referring Only - DentistPractitioner - Dentist 4789961780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31970TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1083066260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2731 FM 1463 RD",
            "address_2": "SUITE 500",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774943828",
            "telephone_number": "281-712-6980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2731 FM 1463 RD",
            "address_2": "SUITE 500",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774943828",
            "telephone_number": "281-712-6980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "DIANA",
        "middle_name": "CAROLINA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "PEREZ",
            "middle_name": "CAROLINA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.