Sergio Correa, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

32050 Issued in CA

Practice address

433 Estudillo Ave
Suite 200
San Leandro, CA 94577-4915

Phone

(510) 351-1016

Fax

(510) 351-2510

NPI assigned

Dec 22, 2006

Last updated

Jan 13, 2021By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1508920497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 ESTUDILLO AVE",
            "address_2": "SUITE 200",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774915",
            "telephone_number": "510-351-1016",
            "fax_number": "510-351-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 ESTUDILLO AVE",
            "address_2": "SUITE 200",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774915",
            "telephone_number": "510-351-1016",
            "fax_number": "510-351-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA",
        "first_name": "SERGIO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "32050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodney Leon Cornist Dhati, ASW
• Rodrigo Corona Flores
• Marina Coronado
• Jessica Coronel
• Diana M Correa
• Tessa Corrie
• Diana Catalina Cortes, B.S.
• Kasey Dawn Cortese, M.D.
• Tiffany Cortese
• Natalia M Cortez, PA-C

• General Practice Dentistry in San Leandro, CA
• Providers in San Leandro, 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 Jan 13, 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.