Ruben D Diaz, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

048339-1 Issued in NY

Practice address

4010 National St
Corona, NY 11368-2321

Phone

(718) 505-0942

Fax

(718) 505-0934

NPI assigned

Oct 21, 2005

Sex

Male

Sole proprietor

No

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

Enrolled in NY

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366432304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HARTWELL PL",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981222",
            "telephone_number": "718-505-0942",
            "fax_number": "718-505-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 NATIONAL ST",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682321",
            "telephone_number": "718-505-0942",
            "fax_number": "718-505-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "RUBEN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048339-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Krikor Derderian, DDS
• Matthew Ryan Di Micelli, RN
• Howard Diamond, DPM
• Christian Diaz
• Crystal Mercedes Diaz
• Nazli Diba, DDS
• Jennifer Disla
• Arthur Dolan, RN
• Chantellee Doyley, MS.ED
• Dr Nisim Pilosov Optometrist PLLC

• General Practice Dentistry in Corona, NY
• Providers in Corona, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.