NPIMap

Organization Active NPI

Maritone Suansing-Olaer, DDS, Inc.

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1073763132
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
55264 Issued in CA
Legal business name
MARITONE SUANSING-OLAER, DDS, INC.
Practice address
4867 Eagle Rock Blvd Ste a
Los Angeles, CA 90041-2657
Phone
(323) 257-4086
Fax
(323) 257-4181
NPI assigned
Sep 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Authorized official

Name
Mrs. Vivian V. Tecson
Title
Treatment Coordinator
Phone
(323) 257-4086

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 55264 CA Primary

Addresses

Primary practice location

4867 Eagle Rock Blvd Ste a
Los Angeles, CA 90041-2657

Mailing address

4867 Eagle Rock Blvd Ste a
Los Angeles, CA 90041-2657
Phone (323) 257-4086

National Provider Directory

National Provider Directory

Locations

4867 Eagle Rock Blvd
Ste A
Los Angeles, CA 90041
Phone (323) 257-4086

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222300800000",
    "number": "1073763132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4867 EAGLE ROCK BLVD STE A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900412657",
            "telephone_number": "323-257-4086",
            "fax_number": "323-257-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4867 EAGLE ROCK BLVD STE A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900412657",
            "telephone_number": "323-257-4086",
            "fax_number": "323-257-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARITONE SUANSING-OLAER, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-25",
        "last_updated": "2008-09-25",
        "status": "A",
        "authorized_official_last_name": "TECSON",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "TREATMENT COORDINATOR",
        "authorized_official_telephone_number": "323-257-4086",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; 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.