Individual provider Active NPI

Margaret Mauleon Novicio, DDS

  • General Practice Dentistry
  • Rancho Santa Fe, CA
National Provider Identifier
1073608089
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
62389 Issued in CA
Practice address
5531 Cancha de Golf Ste 102
Rancho Santa Fe, CA 92091-4625
Phone
(858) 367-3058
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 62389 CA Primary

Addresses

Primary practice location

5531 Cancha de Golf Ste 102
Rancho Santa Fe, CA 92091-4625

Mailing address

5531 Cancha de Golf Ste 102
Rancho Santa Fe, CA 92091-4625
Phone (858) 367-3058

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

LicenseStateTypeSpecialty
62389CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Aldawoodi DMD, Professional Corp CurrentSince Sep 28, 2021 Accepting new patients
Cox Dental Corporation General Practice PastSince Jan 1, 2020 Accepting new patients
Crossroads Dental Group, LLP General Practice Past Accepting new patients

Locations

5531 Cancha de Golf
Ste 102
Rancho Santa Fe, CA 92091
Phone (858) 367-3058

Interoperability endpoints

  • Direct secure messaging: mnovicio@direct.westerndental.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1073608089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5531 CANCHA DE GOLF STE 102",
            "city": "RANCHO SANTA FE",
            "state": "CA",
            "postal_code": "920914625",
            "telephone_number": "858-367-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5531 CANCHA DE GOLF STE 102",
            "city": "RANCHO SANTA FE",
            "state": "CA",
            "postal_code": "920914625",
            "telephone_number": "858-367-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVICIO",
        "first_name": "MARGARET",
        "middle_name": "MAULEON",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "62389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Santa Fe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.