Individual provider Active NPI

Lynn Diaz, D.D.S.

  • Endodontics
  • Moreno Valley, CA
National Provider Identifier
1356546741
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
42728 Issued in CA
Practice address
24099 Postal Ave
Suite 101
Moreno Valley, CA 92553-7709
Phone
(951) 601-1290
Fax
(951) 601-1292
NPI assigned
Jun 18, 2007
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
Endodontics 1223E0200X 42728 CA Primary

Addresses

Primary practice location

24099 Postal Ave
Suite 101
Moreno Valley, CA 92553-7709

Mailing address

24099 Postal Ave
Suite 101
Moreno Valley, CA 92553-7709
Phone (951) 601-1290

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
I20150803002808 CA Order and Referring Only - DentistPractitioner - Dentist 7012221120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
42728CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn Daz, D.D.S. ,Inc. Endodontics CurrentSince Jul 23, 2023 Accepting new patients

Locations

24099 Postal Ave
Ste 101
Moreno Valley, CA 92553
Phone (951) 601-1290

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356546741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24099 POSTAL AVE",
            "address_2": "SUITE 101",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925537709",
            "telephone_number": "951-601-1290",
            "fax_number": "951-601-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24099 POSTAL AVE",
            "address_2": "SUITE 101",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925537709",
            "telephone_number": "951-601-1290",
            "fax_number": "951-601-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "42728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.