Jennifer C Diaz, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

48254 Issued in CA

Practice address

263 Davis St
San Leandro, CA 94577-2742

Phone

(510) 861-3471

Fax

(510) 357-8898

NPI assigned

Jul 26, 2023

Last updated

Jul 26, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Diaz-Maniego Professional Dental Corporation

  dba san leandro plaza dental office

  • General Practice Dentistry
  • San Leandro, CA
  • NPI 1740490598
  NPD (past)

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1184305880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 DAVIS ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945772742",
            "telephone_number": "510-357-8878",
            "fax_number": "510-357-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 DAVIS ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945772742",
            "telephone_number": "510-861-3471",
            "fax_number": "510-357-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JENNIFER",
        "middle_name": "C",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "48254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diablo Infectious Disease Consultative Service Med GRP Inc
• Marc Joseph Diamond, L.C.S.W.
• Tatiana Del Pilar Diaz Cubillos, LVN
• Diaz-Maniego Professional Dental Corporation (san leandro plaza dental office)
• Alejandra Diaz
• Lizbeth Diaz
• Tiffany Diaz
• Wilfredo Zaulda Diaz
• Yessenia Diaz
• Claudia Diep

• Dentist in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; 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.