Healthcare Provider Details

I. General information

NPI: 1316942196
Provider Name (Legal Business Name): JOCELYN PEREY REYES DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOCELYN ERNI PEREY DMD

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2161 E. PROSPERITY AVE
TULARE CA
93274
US

IV. Provider business mailing address

3612 W OAKRIDGE AVE
VISALIA CA
93291
US

V. Phone/Fax

Practice location:
  • Phone: 559-358-3911
  • Fax: 559-741-9923
Mailing address:
  • Phone: 469-837-5343
  • Fax: 559-734-7148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number50954
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number50954
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: