Active NPI
Alexander V Marose
- Dentist
- Mission Viejo, CA
National Provider Identifier
1083966972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 61710
- Practice address
- 25542 Jeronimo Rd Ste 3
Mission Viejo, CA 92691-2724 - Phone
- (949) 457-0223
- Fax
- (949) 588-2766
- NPI assigned
- Oct 3, 2012
- Last updated
- Nov 1, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 61710 | CA | Primary |
Addresses
Primary practice location
25542 Jeronimo Rd Ste 3
Mission Viejo, CA 92691-2724
Mailing address
25542 Jeronimo Rd Ste 3
Mission Viejo, CA 92691-2724
Phone (949) 874-0025
Other practice location 1
154 Plaza Dr
West Covina, CA 91790-2873
Phone (626) 962-1700
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61710 | CA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alex Marose DDS Inc. | Current | Accepting new patients | |
| James N Vartanian, DDS Inc | Dentist | Current | Accepting new patients |
| Dr a Winter a Profession Corporation | Past | Accepting new patients | |
| Dental Excellence Inc. | Dentist | Past | Accepting new patients |
Locations
1855 N Hacienda Blvd
La Puente, CA 91744
Phone (626) 699-6115
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Alex Marose DDS
- Oral and Maxillofacial Surgery (Dentist)
- La Puente, CA
- NPI 1013537604
-
- Dentist
- Mission Viejo, CA
- NPI 1306999818
-
- Dentist
- Mission Viejo, CA
- NPI 1285059345
-
- Dentist
- San Clemente, CA
- NPI 1205989852
-
- General Practice Dentistry
- West Covina, CA
- NPI 1205264587
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604188800000",
"number": "1083966972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25542 JERONIMO RD STE 3",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926912724",
"telephone_number": "949-874-0025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25542 JERONIMO RD STE 3",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926912724",
"telephone_number": "949-457-0223",
"fax_number": "949-588-2766"
}
],
"practiceLocations": [
{
"address_1": "154 Plaza Dr",
"address_purpose": "LOCATION",
"city": "West Covina",
"state": "CA",
"postal_code": "917902873",
"country_code": "US",
"telephone_number": "626-962-1700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAROSE",
"first_name": "ALEXANDER",
"middle_name": "V",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-03",
"last_updated": "2020-11-01",
"certification_date": "2020-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "61710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mission Viejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.