Individual provider Active NPI

Maithili Bapat Marathe, D.D.S.

  • Dentist
  • Long Beach, CA
National Provider Identifier
1043663479
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
100336 Issued in CA
Practice address
6437 E Pacific Coast Hwy
Unit a-6
Long Beach, CA 90803-4201
Phone
(562) 735-3623
NPI assigned
Jul 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 100336 CA Primary

Addresses

Primary practice location

6437 E Pacific Coast Hwy
Unit a-6
Long Beach, CA 90803-4201

Mailing address

28 Country Ridge Rd
Pomona, CA 91766-4815
Phone (909) 374-1731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170228000518 CA Order and Referring Only - DentistPractitioner - Dentist 6608150230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100336CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1043663479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 COUNTRY RIDGE RD",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917664815",
            "telephone_number": "909-374-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6437 E PACIFIC COAST HWY",
            "address_2": "UNIT A-6",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034201",
            "telephone_number": "562-735-3623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARATHE",
        "first_name": "MAITHILI",
        "middle_name": "BAPAT",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.