Individual provider Active NPI

Christine Diblasi, D.D.S.

  • General Practice Dentistry
  • Raleigh, NC
National Provider Identifier
1700041845
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7126 Issued in NC
Practice address
415 Vick Ave
Raleigh, NC 27612-5025
Phone
(919) 787-0355
NPI assigned
Jul 28, 2008
Last updated
Apr 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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 7126 NC Primary

Addresses

Primary practice location

415 Vick Ave
Raleigh, NC 27612-5025

Mailing address

415 Vick Ave
Raleigh, NC 27612-5025
Phone (919) 787-0355

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
7126NCMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Christine D. Laster, DDS, PA General Practice Past Accepting new patients
Brandon D. Rensch, D.D.S., PLLC General Practice PastSince Oct 17, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1700041845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 VICK AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125025",
            "telephone_number": "919-787-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 VICK AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125025",
            "telephone_number": "919-787-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBLASI",
        "first_name": "CHRISTINE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.