Kristina Caravelli, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

106891 Issued in CA

Practice address

2115 Bacon St
San Diego, CA 92107-2109

Phone

(619) 224-2986

NPI assigned

Nov 14, 2021

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr Pablo Enrique Liciaga DDS

  • Dentist
  • San Diego, CA
  • NPI 1295801561
  NPD (past)

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

{
    "created_epoch": "1636848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636848000000",
    "number": "1487310405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2779 OCEAN FRONT WALK",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921098261",
            "telephone_number": "203-770-4894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 BACON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921072109",
            "telephone_number": "619-224-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARAVELLI",
        "first_name": "KRISTINA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-14",
        "last_updated": "2021-11-14",
        "certification_date": "2021-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "106891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarita R Carambas, MD
• Vlady Mando Carandang, RN
• Carla Gail Gabison Carangue, BS
• Angelica Valencia Caranza, CPHT/LICENSE TECH
• Ashley Caravella, MFT
• Mary E Caravello, CRNP
• Arlene Caraway
• Matthew Ross Carazo, M.D.
• Kristy J Carazolez
• Lydia Carbajal

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2021; 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.