Active NPI
Nolasco T Sta Ana, D.M.D.
- Dentist
- Corona, CA
National Provider Identifier
1942553722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 035341
- Practice address
- 1252 West 6TH Street
Suite 103
Corona, CA 92882-8207 - Phone
- (951) 371-7998
- NPI assigned
- Oct 18, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 035341 | CA | Primary |
Addresses
Primary practice location
1252 West 6TH Street
Suite 103
Corona, CA 92882-8207
Mailing address
2560 West Lincoln Avenue
Anaheim, CA 92801-6432
Phone (714) 110-9647
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
| License | State | Type | Specialty |
|---|---|---|---|
| 035341 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nolasco Sta Ana DMD Inc | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Anaheim, CA
- NPI 1720282734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350518400000",
"number": "1942553722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2560 WEST LINCOLN AVENUE",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928016432",
"telephone_number": "714-110-9647",
"fax_number": "714-220-0375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1252 WEST 6TH STREET",
"address_2": "SUITE 103",
"city": "CORONA",
"state": "CA",
"postal_code": "928828207",
"telephone_number": "951-371-7998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STA ANA",
"first_name": "NOLASCO",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-18",
"last_updated": "2012-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "035341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.