Individual provider Active NPI

Carlos A Diaz, DDS

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1497019822
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27958 Issued in TX
Practice address
1101 Camino la Costa
Austin, TX 78752-3930
Phone
(512) 478-4939
NPI assigned
Jun 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 27958 TX
General Practice Dentistry 1223G0001X 27958 TX Primary

Addresses

Primary practice location

1101 Camino la Costa
Austin, TX 78752-3930

Mailing address

1101 Camino la Costa
Austin, TX 78752-3930
Phone (512) 478-4939

Other identifiers 1

IdentifierTypeStateIssuer
27958OtherTXSTATE LICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120814000516 TX Practitioner - DentistPractitioner - Oral Surgery 5193971760 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peoples Community Clinic Inc Current Accepting new patients
People'S Community Clinic, Inc. Past Accepting new patients

Locations

1101 Camino La Costa
Austin, TX 78752
Phone (512) 478-4939

10335 US Highway 290 E
Bldg 35
Manor, TX 78653
Phone (512) 478-4939

Interoperability endpoints

  • Direct secure messaging: cdiaz663436@direct.ochin.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1497019822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 CAMINO LA COSTA",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523930",
            "telephone_number": "512-478-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 CAMINO LA COSTA",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523930",
            "telephone_number": "512-478-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "CARLOS",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-29",
        "last_updated": "2025-05-13",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "27958",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "27958",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.