Individual provider Active NPI

Armentina Diao Light, DDS

  • Dentist
  • Aliso Viejo, CA
National Provider Identifier
1992848998
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
39980 Issued in CA
Practice address
15 Mareblu
Suite 280
Aliso Viejo, CA 92656-3015
Phone
(949) 362-1142
Fax
(949) 362-4102
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 39980 CA Primary

Addresses

Primary practice location

15 Mareblu
Suite 280
Aliso Viejo, CA 92656-3015

Mailing address

15 Mareblu
Suite 280
Aliso Viejo, CA 92656-3067
Phone (949) 362-1142

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

LicenseStateTypeSpecialty
39980CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992848998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MAREBLU",
            "address_2": "SUITE 280",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563067",
            "telephone_number": "949-362-1142",
            "fax_number": "949-362-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MAREBLU",
            "address_2": "SUITE 280",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563015",
            "telephone_number": "949-362-1142",
            "fax_number": "949-362-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "ARMENTINA",
        "middle_name": "DIAO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "39980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aliso Viejo, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.