George M. Correa, DMD, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30542 Issued in CA

Legal business name

GEORGE M. CORREA, DMD, INC.

Practice address

509 Marin St Ste 220
Thousand Oaks, CA 91360-4230

Phone

(805) 374-8484

Fax

(805) 374-9819

NPI assigned

Mar 13, 2013

Last updated

Mar 13, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. George Correa, D.M.D.NPI 1063626539

Title

Owner

Phone

(805) 374-8484

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• George Mark Correa, D.M.D.

  • Dentist
  • Thousand Oaks, CA
  • NPI 1063626539
  Authorized official Same address or phone

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363132800000",
    "number": "1396086450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 MARIN ST STE 220",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913604230",
            "telephone_number": "805-374-8484",
            "fax_number": "805-374-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 MARIN ST STE 220",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913604230",
            "telephone_number": "805-374-8484",
            "fax_number": "805-374-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE M. CORREA, DMD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-13",
        "last_updated": "2013-03-13",
        "status": "A",
        "authorized_official_last_name": "CORREA",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-374-8484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; 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.