Marivin Oto, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D3750 Issued in ID

Practice address

317 W Cherry LN
Meridian, ID 83642-1608

Phone

(208) 888-2055

Fax

(208) 895-0583

NPI assigned

Nov 11, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1023189131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 W CHERRY LN",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421608",
            "telephone_number": "208-888-2055",
            "fax_number": "208-895-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 W CHERRY LN",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421608",
            "telephone_number": "208-888-2055",
            "fax_number": "208-895-0583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTO",
        "first_name": "MARIVIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8067150",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kody Quentin Osborne, DMD
• Osteoarthritis Centers of America Medical Group PC (OsteoArthritis Centers of America)
• Jan Osterberg
• Mariya Rose Ostermiller, MPAS, PA-C
• Sis E Ostolasa, PA
• Sophie Otradovec
• Barbara A Ottenhoff, PSYD
• Allyson Overton, MS CCC-SLP
• Kristin Michelle Overton, LMSW
• Linda Krystle Morales Overton, CST

• General Practice Dentistry in Meridian, ID
• Providers in Meridian, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.