Mario J Olivotto, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61568 Issued in CA

Practice address

9855 Erma Rd
Suite 103
San Diego, CA 92131-3001

Phone

(858) 578-0120

NPI assigned

Jan 30, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1104164888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15996 TURTLEBACK RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921272031",
            "telephone_number": "310-490-8046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9855 ERMA RD",
            "address_2": "SUITE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313001",
            "telephone_number": "858-578-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVOTTO",
        "first_name": "MARIO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-30",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA DENTAL LICENSE",
            "identifier": "61568",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lalainemae Corvilla Oliveria, LMFT
• Glenda J Olivier, PHD
• Alana Marie Olivieri
• Avril Isabella Olivo Paniagua
• Cassandra Olivo
• Alice Olliff, RN,BSN,PHN
• Joshua Ollison, BA, MASTERS
• Juan Jr. Olmeda, CDI
• Angelli Olmedo
• Angelo Olmedo, MD

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.