Active NPI
Kritika Jo Carrazana, D.D.S.
- Pediatric Dentistry
- Pacific Grove, CA
National Provider Identifier
1659738367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 107451
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 30.025523 | OH | MD | Dentist |
| 107451 | CA | MD | Pediatric Dentist |
| 61137 | KS | MD | Pediatric Dentist |
| 2016014866 | MO | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carrazana, DDS, Apdc | Pediatric Dentistry | Current | 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.
-
- General Practice Dentistry
- Pacific Grove, CA
- NPI 1912631474
Pediatric Dentistry
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.