Cristian Fernandez, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

51063 Issued in CA

Practice address

555 W Benjamin Holt Dr
Suite 100
Stockton, CA 95207-3839

Phone

(209) 473-7888

NPI assigned

Apr 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 22, 2015 through Oct 22, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cristian J Fernandez DDS Inc

  • Dentist
  • San Ramon, CA
  • NPI 1932821550
  NPD Authorized official

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952526832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W BENJAMIN HOLT DR",
            "address_2": "BUILDING B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952073839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W BENJAMIN HOLT DR",
            "address_2": "SUITE 100",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952073839",
            "telephone_number": "209-473-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "CRISTIAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew John Fernandes, AMFT
• Richlyn Dawne Fernandes, DDS
• Sylvia Fernandes, M.D.
• Karla Gabriela Fernandez-Felix
• Alberto Fernandez
• Divina Javier Fernandez, NURSE PRACTITIONER
• Imari Antoinette Fernandez
• Joselyn Fernandez
• Lourdes Cortes Fernandez, X-RAY TECHNICIAN
• Mirian Fernandez, LCSW

• General Practice Dentistry in Stockton, CA
• Providers in Stockton, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.