Individual provider Active NPI

Krissia Delmy Romero Morales, DDS

  • General Practice Dentistry
  • Alameda, CA
National Provider Identifier
1912776162
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
109779 Issued in CA
Practice address
310 Jack London Ave
Alameda, CA 94501-3171
Phone
(415) 654-8247
NPI assigned
Dec 29, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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 109779 CA Primary

Addresses

Primary practice location

310 Jack London Ave
Alameda, CA 94501-3171

Mailing address

310 Jack London Ave
Alameda, CA 94501-3171
Phone (415) 654-8247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240624001401 CA Order and Referring Only - DentistPractitioner - Dentist 6800339433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109779CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1912776162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 JACK LONDON AVE",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945013171",
            "telephone_number": "415-654-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 JACK LONDON AVE",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945013171",
            "telephone_number": "415-654-8247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO MORALES",
        "first_name": "KRISSIA",
        "middle_name": "DELMY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-29",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alameda, CA

Sources for this page

Verify at the official NPI Registry.