Individual provider Active NPI

Danica Charisma Mallari, DMD

  • Dentist
  • San Diego, CA
National Provider Identifier
1083374482
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS107163 Issued in CA
Practice address
2995 Clairemont Dr Ste a
San Diego, CA 92117-6766
Phone
(858) 200-0827
NPI assigned
Dec 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS107163 CA Primary

Addresses

Primary practice location

2995 Clairemont Dr Ste a
San Diego, CA 92117-6766

Mailing address

2995 Clairemont Dr Ste a
San Diego, CA 92117-6766
Phone (858) 200-0827

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
DDS107163CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Huynh and Habashi Dental Corporation Dentist PastSince Jan 2, 2022 Accepting new patients

Organizations & group practices 1

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": "1640563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1083374482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 CLAIREMONT DR STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176766",
            "telephone_number": "858-200-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2995 CLAIREMONT DR STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176766",
            "telephone_number": "858-200-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLARI",
        "first_name": "DANICA",
        "middle_name": "CHARISMA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-27",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS107163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.