Diana Correavelosa DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DIANA CORREAVELOSA DDS INC

Practice address

7614 N Fresno St Ste 105
Fresno, CA 93720-7406

Phone

(559) 435-3344

Fax

(559) 435-6658

NPI assigned

Feb 4, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Diego F Velosa

Title

Director

Phone

(559) 435-3444

Specialties & licenses 1

Addresses

Other names 1

• Crystal Dental of Fresno Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diana Cristina Correa-Velosa, D.D.S

  • Dentist
  • Fresno, CA
  • NPI 1437343415

  General Practice

  NPD (past)

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549238400000",
    "number": "1104381110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7614 N FRESNO ST STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937207406",
            "telephone_number": "559-435-3344",
            "fax_number": "559-435-6658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7614 N FRESNO ST STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937207406",
            "telephone_number": "559-435-3344",
            "fax_number": "559-435-6658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANA CORREAVELOSA DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-04",
        "last_updated": "2019-02-04",
        "status": "A",
        "authorized_official_last_name": "VELOSA",
        "authorized_official_first_name": "DIEGO",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "559-435-3444"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crystal Dental of Fresno",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Fresno, CA
• Providers in Fresno, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; 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.