Individual provider Active NPI

Kritika Jo Carrazana, D.D.S.

  • Pediatric Dentistry
  • Pacific Grove, CA
National Provider Identifier
1659738367
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
107451 Issued in CA
Practice address
675 Pine Ave
Pacific Grove, CA 93950-3373
Phone
(831) 649-1055
NPI assigned
Jan 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.025523 OH
Pediatric Dentistry 1223P0221X 61137 KS
Pediatric Dentistry 1223P0221X 2016014866 MO
Pediatric Dentistry 1223P0221X 107451 CA Primary

Addresses

Primary practice location

675 Pine Ave
Pacific Grove, CA 93950-3373

Mailing address

3123 Copper Peak Dr
Dublin, CA 94568-4901
Phone (772) 563-3540

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

LicenseStateTypeSpecialty
30.025523OHMDDentist
107451CAMDPediatric Dentist
61137KSMDPediatric Dentist
2016014866MOMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Carrazana, DDS, Apdc Pediatric Dentistry CurrentSince Jul 17, 2022 Accepting new patients

Locations

675 Pine Ave
Pacific Grove, CA 93950
Phone (831) 649-1055

Organizations & group practices 1

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": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1659738367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3123 COPPER PEAK DR",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945684901",
            "telephone_number": "772-563-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 PINE AVE",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939503373",
            "telephone_number": "831-649-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRAZANA",
        "first_name": "KRITIKA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.025523",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KS",
            "license": "61137",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "2016014866",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "107451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.

Verify at the official NPI Registry.