Active NPI
Diana Cristina Correa-Velosa, D.D.S
- Dentist
- Fresno, CA
National Provider Identifier
1437343415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 56250
- Practice address
- 7614 N. Fresno Street
Suite 105
Fresno, CA 93720 - Phone
- (559) 435-3344
- Fax
- (559) 435-3344
- NPI assigned
- Aug 31, 2007
- Last updated
- Oct 8, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 56250 | CA | Primary |
| General Practice Dentistry | 1223G0001X | 56250 | CA |
Addresses
Primary practice location
7614 N. Fresno Street
Suite 105
Fresno, CA 93720
Mailing address
7614 N. Fresno Street
Ste. 105
Fresno, CA 93720
Phone (559) 435-3344
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56250 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diana Correavelosa DDS Inc | General Practice | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Crystal Dental of Fresno
- General Practice Dentistry
- Fresno, CA
- NPI 1104381110
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538956800000",
"number": "1437343415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7614 N. FRESNO STREET",
"address_2": "STE. 105",
"city": "FRESNO",
"state": "CA",
"postal_code": "93720",
"telephone_number": "559-435-3344",
"fax_number": "559-435-6658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7614 N. FRESNO STREET",
"address_2": "SUITE 105",
"city": "FRESNO",
"state": "CA",
"postal_code": "93720",
"telephone_number": "559-435-3344",
"fax_number": "559-435-3344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORREA-VELOSA",
"first_name": "DIANA",
"middle_name": "CRISTINA",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-31",
"last_updated": "2018-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "56250",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "56250",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.