Fredrick a Correa DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

26369 Issued in CA

Legal business name

FREDRICK A CORREA DDS INC

Practice address

1603 Eureka Rd
Roseville, CA 95661-3028

Phone

(916) 782-8436

NPI assigned

May 15, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Fredrick Correa, DDS

Title

Owner

Phone

(916) 782-8436

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431648000000",
    "number": "1245618743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 EUREKA RD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613028",
            "telephone_number": "916-782-8436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 EUREKA RD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613028",
            "telephone_number": "916-782-8436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDRICK A CORREA DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-15",
        "last_updated": "2015-05-15",
        "status": "A",
        "authorized_official_last_name": "CORREA",
        "authorized_official_first_name": "FREDRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-782-8436",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "26369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Roseville, CA
• Providers in Roseville, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; 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.