Jessie Corral, D.D.S

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

44857 Issued in CA

Practice address

2600 Oswell St Ste F
Bakersfield, CA 93306-3159

Phone

(661) 871-4132

Fax

(661) 872-0943

NPI assigned

Feb 20, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1194860809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9396 GLENAIRE CT",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305775",
            "telephone_number": "909-476-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 OSWELL ST STE F",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933063159",
            "telephone_number": "661-871-4132",
            "fax_number": "661-872-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRAL",
        "first_name": "JESSIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44857",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "44857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmin G Coronado
• Sylvia Coronado
• Jessica Abissay Corral-Mangon
• Adam Corral
• Adriana Corral, LCSW
• Maria Corral
• Mercedes Corral
• Noemi Corral
• Kathya Corrales
• Brianna Alexia Correa

• Oral and Maxillofacial Surgery (Dentist) in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.