J. a. Mirelez Jr DDS Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

J. A. MIRELEZ JR DDS INC.

Doing business as

Mirelez Revitalize Dental Implant Center

Practice address

145 N Clovis Ave Ste 102
Clovis, CA 93612-0361

Phone

(559) 314-1310

Fax

(559) 314-1311

NPI assigned

Sep 25, 2024

Organization subpart

No

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

Authorized official

Name

Jose A Mirelez, DDSNPI 1619045325

Title

Owner

Phone

(559) 977-6565

Specialties & licenses 1

Addresses

Other names 1

• Mirelez Revitalize Dental Implant Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jose A. Mirelez, D.D.S

  • General Practice Dentistry
  • Fresno, CA
  • NPI 1619045325
  NPD Authorized official

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1700603271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 N CLOVIS AVE STE 102",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120361",
            "telephone_number": "559-314-1310",
            "fax_number": "559-314-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 N CLOVIS AVE STE 102",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120361",
            "telephone_number": "559-314-1310",
            "fax_number": "559-314-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. A. MIRELEZ JR DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "MIRELEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-977-6565",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mirelez Revitalize Dental Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Integrity Medical Group Corp
• Visaka Dianna Inthavong, OD
• Cory Ipsen, PA-C
• Erika Lezann Ireland, RDN
• Alan Todd Israel, O.D.
• Sara Jamal Jaber
• Kimberly Erin Jackson-Massaro, MSW/LCSW
• Danielle Erin Jackson, FNP
• Mark Henry Jackson, LCSW
• Rebecca Jackson

• Oral and Maxillofacial Surgery (Dentist) in Clovis, CA
• Providers in Clovis, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.