Gabriella Danielle Diaz, DDS, MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

35975 Issued in TX

Practice address

5419 Fredericksburg Rd
San Antonio, TX 78229-3503

Phone

(210) 616-0980

NPI assigned

Apr 6, 2021

Last updated

Dec 7, 2022By the provider in NPPES

Sex

Female

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 TX

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

State licenses

Practice roles

Locations

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.

• TX Southern Dental PPO PC

  dba Oak Hills Periodontics

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1508547886
  NPD

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1487233664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11215 ANAQUA SPGS",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780068493",
            "telephone_number": "817-300-6658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5419 FREDERICKSBURG RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293503",
            "telephone_number": "210-616-0980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7500 Cambridge St Ste 6470",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770542032",
            "country_code": "US",
            "telephone_number": "817-300-6658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "GABRIELLA",
        "middle_name": "DANIELLE",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "35975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Ann Diaz
• Denise Diaz, RBT
• Elizabeth H Diaz, PA-C
• Elvia Guadalupe Diaz, COTA
• Eric Diaz
• Gabrielle Renee Diaz
• George Diaz
• Giancarlo Andres Diaz, MD
• Heidi Diaz, M.S., CCC-SLP
• Ivonne Diaz, PHARM D

• Periodontics in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.