NPIMap

Organization Active NPI

Eduardo Diaz Dental Corporation

  • Dental Clinic/Center
  • Chula Vista, CA
National Provider Identifier
1821223934
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
44306 Issued in CA
Legal business name
EDUARDO DIAZ DENTAL CORPORATION
Practice address
890 Eastlake Pkwy
Suite 303
Chula Vista, CA 91914-4520
Phone
(619) 216-0111
Fax
(619) 216-7081
NPI assigned
May 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Authorized official

Name
Dr. Eduardo Diaz, D.D.S., PC, ICOINPI 1922157288
Title
President
Phone
(619) 216-0111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 44306 CA Primary

Addresses

Primary practice location

890 Eastlake Pkwy
Suite 303
Chula Vista, CA 91914-4520

Mailing address

890 Eastlake Pkwy
Suite 303
Chula Vista, CA 91914-4520
Phone (619) 216-0111

Other identifiers 1

IdentifierTypeStateIssuer
1922157288OtherCANPI

Other names 1

  • EASTLAKE IMPLANT & LASER DENTISTRY Doing business as

National Provider Directory

National Provider Directory

Locations

890 Eastlake Pkwy
Ste 303
Chula Vista, CA 91914
Phone (619) 216-0111

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312416000000",
    "number": "1821223934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 EASTLAKE PKWY",
            "address_2": "SUITE 303",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144520",
            "telephone_number": "619-216-0111",
            "fax_number": "619-216-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 EASTLAKE PKWY",
            "address_2": "SUITE 303",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144520",
            "telephone_number": "619-216-0111",
            "fax_number": "619-216-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUARDO DIAZ DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-18",
        "last_updated": "2011-08-04",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-216-0111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., PC, ICOI"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "44306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1922157288",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EASTLAKE IMPLANT & LASER DENTISTRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.