Active NPI
Kristina Danielle Fernandez, DDS
- Dentist
- Long Beach, CA
National Provider Identifier
1487292116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 103877
- Practice address
- 3530 Atlantic Ave
Long Beach, CA 90807-4569 - Phone
- (909) 915-5292
- NPI assigned
- Dec 12, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 103877 | CA | Primary |
Addresses
Primary practice location
3530 Atlantic Ave
Long Beach, CA 90807-4569
Mailing address
1205 Pintado
Irvine, CA 92618-0212
Phone (909) 915-5292
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 |
|---|---|---|---|
| 103877 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576108800000",
"number": "1487292116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1205 PINTADO",
"city": "IRVINE",
"state": "CA",
"postal_code": "926180212",
"telephone_number": "909-915-5292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3530 ATLANTIC AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908074569",
"telephone_number": "909-915-5292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "KRISTINA",
"middle_name": "DANIELLE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-12",
"last_updated": "2019-12-12",
"certification_date": "2019-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "103877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.