Active NPI
Jessica Ma, D.D.S
- Dentist
- San Jose, CA
National Provider Identifier
1104376052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 100609
- Practice address
- 242 La Pala Dr
San Jose, CA 95127-2103 - Phone
- (669) 900-0030
- Fax
- (408) 963-0143
- NPI assigned
- Oct 4, 2016
- Sex
- Female
- 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 | 100609 | CA | Primary |
Addresses
Primary practice location
242 La Pala Dr
San Jose, CA 95127-2103
Mailing address
1061 Weyburn Lane
San Jose, CA 95129
Phone (408) 666-6002
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
| License | State | Type | Specialty |
|---|---|---|---|
| 100609 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476662400000",
"number": "1104376052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 WEYBURN LANE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95129",
"telephone_number": "408-666-6002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 LA PALA DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951272103",
"telephone_number": "669-900-0030",
"fax_number": "408-963-0143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MA",
"first_name": "JESSICA",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-04",
"last_updated": "2016-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "100609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.