Eduardo Diaz Dental Corporation
Clinic/Center, Dental in Chula Vista, CA. Organization (NPI-2).
NPI number1821223934
StatusActive
Last updated in NPPESAug 4, 2011
Details
- NPI
- 1821223934
- Entity type
- Organization (NPI-2)
- Legal business name
- Eduardo Diaz Dental Corporation
- Organization subpart
- No
- Enumeration date
- May 18, 2009
- Last updated
- Aug 4, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | 44306 | CA | Yes |
Other names
- Eastlake Implant & Laser Dentistry (Doing Business As)
Practice location
890 Eastlake PkwySuite 303
Chula Vista, CA 91914-4520
Phone 619-216-0111 · Fax 619-216-7081
Mailing address
890 Eastlake PkwySuite 303
Chula Vista, CA 91914-4520
Phone 619-216-0111 · Fax 619-216-7081
Authorized official
Eduardo Diaz
President
6192160111
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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