Dr.Keri,a Professional Corporation

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

42542 Issued in CA

Legal business name

DR.KERI,A PROFESSIONAL CORPORATION

Practice address

11943 El Camino Real
Ste 200
San Diego, CA 92130-2597

Phone

(619) 216-7336

Fax

(619) 216-2084

NPI assigned

Jul 17, 2013

Last updated

Jul 17, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Laura Elena Flores

Title

Office Manager

Phone

(619) 591-2642

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1861833998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2226 OTAY LAKES RD",
            "address_2": "STE A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919151010",
            "telephone_number": "619-216-7336",
            "fax_number": "619-216-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11943 EL CAMINO REAL",
            "address_2": "STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302597",
            "telephone_number": "619-216-7336",
            "fax_number": "619-216-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR.KERI,A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-17",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "ELENA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "619-591-2642",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "42542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; 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.