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General NPI Number Information
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NPI Number | 1558284364
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Entity Type | Individual
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Provider Name | JENNIFER TORRES DIAZ DMD
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Gender | Female
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 372 N SUNRISE AVE STE 200
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City | ROSEVILLE
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State | CA
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Zip | 95661-2812
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Country | US
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Telephone | 916-839-3039
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Fax |
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Provider Business Mailing Address
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Address Line | 508 DOUGLAS ST UNIT 204
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City | WEST SACRAMENTO
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State | CA
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Zip | 95605-2510
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Country | US
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Telephone | 209-605-7287
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 113528
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License Number State | CA
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