Individual provider Active NPI

Catherine Irasusta, DMD

  • General Practice Dentistry
  • Fresno, CA
National Provider Identifier
1649280686
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
47256 Issued in CA
Practice address
1575 W Shaw Ave
Fresno, CA 93711-3503
Phone
(559) 221-7303
Fax
(559) 221-7352
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 47256 CA Primary

Addresses

Primary practice location

1575 W Shaw Ave
Fresno, CA 93711-3503

Mailing address

1575 W Shaw Ave
Fresno, CA 93711-3503
Phone (559) 221-7303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160525000798 CA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 4183913528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
47256CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649280686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 W SHAW AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113503",
            "telephone_number": "559-221-7303",
            "fax_number": "559-221-7352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 W SHAW AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113503",
            "telephone_number": "559-221-7303",
            "fax_number": "559-221-7352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRASUSTA",
        "first_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.