Active NPI
Cory Daley
- Pediatric Dentistry
- Lodi, CA
National Provider Identifier
1568096113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 107607
- Practice address
- 1361 S Lower Sacramento Rd Ste 601
Lodi, CA 95242-9296 - Phone
- (209) 333-3350
- NPI assigned
- Feb 22, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 107607 | CA | Primary |
Addresses
Primary practice location
1361 S Lower Sacramento Rd Ste 601
Lodi, CA 95242-9296
Mailing address
1361 S Lower Sacramento Rd Ste 601
Lodi, CA 95242-9296
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 |
|---|---|---|---|
| 107607 | CA | MD | Pediatric Dentist |
Interoperability endpoints
- cory.daley.p1@direct.wcchc.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660780800000",
"number": "1568096113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1361 S LOWER SACRAMENTO RD STE 601",
"city": "LODI",
"state": "CA",
"postal_code": "952429296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1361 S LOWER SACRAMENTO RD STE 601",
"city": "LODI",
"state": "CA",
"postal_code": "952429296",
"telephone_number": "209-333-3350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALEY",
"first_name": "CORY",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-02-22",
"last_updated": "2022-08-18",
"certification_date": "2022-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "107607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.