Individual provider Active NPI

Maria Diana G. Tolosa, DMD

  • General Practice Dentistry
  • Daly City, CA
National Provider Identifier
1205030822
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43256 Issued in CA
Practice address
7119 Mission St
Daly City, CA 94014-2202
Phone
(650) 991-2094
Fax
(650) 991-2095
NPI assigned
Jun 14, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 43256 CA Primary

Addresses

Primary practice location

7119 Mission St
Daly City, CA 94014-2202

Mailing address

20 Jacqueline CT
Daly City, CA 94014-1605
Phone (415) 468-8586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160607000310 CA Order and Referring Only - DentistPractitioner - Dentist 1557651395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
43256CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Tolosa Sison Prof. Dental. Corp. General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205030822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 JACQUELINE CT",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940141605",
            "telephone_number": "415-468-8586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7119 MISSION ST",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940142202",
            "telephone_number": "650-991-2094",
            "fax_number": "650-991-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLOSA",
        "first_name": "MARIA DIANA",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.