Kristina Visic, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

63864 Issued in CA

Practice address

1107 Ocean St
Santa Cruz, CA 95060-2818

Phone

(714) 571-3140

NPI assigned

Mar 20, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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)

Enrolled

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1477895191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 DESCANSO DR UNIT 1447",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951341847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 OCEAN ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950602818",
            "telephone_number": "714-571-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISIC",
        "first_name": "KRISTINA",
        "name_prefix": "Ms.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-20",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63864",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Lee Vines
• Timothy James Violago, ATC
• Colette R Virostko
• Nancy Jeanne Virostko, L.C.S.W
• Teri Lynn Virostko, LMFT
• Vista Center for the Blind and Visually Impaired
• Carolyn Vitale
• Deborah June Vitale, D.C.
• Paul Vitali, LMFT
• Vitality Wellness Center, a Medical Corporation

• General Practice Dentistry in Santa Cruz, CA
• Providers in Santa Cruz, 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 Aug 27, 2014; 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.