Healthcare Provider Details

I. General information

NPI: 1922939214
Provider Name (Legal Business Name): MARIA ISABEL MEZA DIAZ DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2775 HIGHLAND AVE STE 103
SELMA CA
93662-3463
US

IV. Provider business mailing address

610 GLORIA AVE
SANGER CA
93657-3565
US

V. Phone/Fax

Practice location:
  • Phone: 559-896-1752
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number112928
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: