Katy Avila Correa, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.031758 Issued in IL

Practice address

1780 N Farnsworth Ave
Aurora, IL 60505-1576

Phone

(630) 585-9333

NPI assigned

Jun 18, 2018

Sex

Female

Sole proprietor

Yes

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 and National Provider Directory roles.

• Grand Dental Associates, P.C.

  • General Practice Dentistry
  • Channahon, IL
  • NPI 1598113805
  NPD (past)

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1245724772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 ROLLING GROVE CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406355",
            "telephone_number": "858-414-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 N FARNSWORTH AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605051576",
            "telephone_number": "630-585-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA",
        "first_name": "KATY",
        "middle_name": "AVILA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.031758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cornucopia Staffing Solutions Corp
• Kelly M Corona
• Narda J. Coronado, D.D.S.
• Laura Corrado, M.S., BCBA
• Araceli Corral
• Julianna Marie Corrigan
• Terry Lynn Corso-Oboyle, AU.D
• Samuel A Corso, DPT
• Angellei Cortes
• Debbie Cortes

• General Practice Dentistry in Aurora, IL
• Providers in Aurora, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; 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.