Active NPI
Maryiam Elizabeth Barkho
- Dentist
- Santa Ana, CA
National Provider Identifier
1013527365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 105001
- Practice address
- 809 South Main Street Suite B
Santa Ana, CA 92701 - Phone
- (800) 755-9771
- NPI assigned
- Aug 2, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 105001 | CA | |
| Dentist | 122300000X | 105001 | CA | Primary |
Addresses
Primary practice location
809 South Main Street Suite B
Santa Ana, CA 92701
Mailing address
3138 Manistee Dr
Costa Mesa, CA 92626-3124
Phone (714) 785-6512
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
| License | State | Type | Specialty |
|---|---|---|---|
| 105001 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1013527365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3138 MANISTEE DR",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926263124",
"telephone_number": "714-785-6512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 SOUTH MAIN STREET SUITE B",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "92701",
"telephone_number": "800-755-9771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARKHO",
"first_name": "MARYIAM",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-02",
"last_updated": "2020-10-26",
"certification_date": "2020-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "105001",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "105001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.