Virgil Salomon Mara I, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

40670 Issued in CA

Practice address

9020 Venice Blvd
Culver City, CA 90232-2305

Phone

(310) 836-3136

NPI assigned

Feb 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114068814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3744 TILDEN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900346912",
            "telephone_number": "310-204-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9020 VENICE BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322305",
            "telephone_number": "310-836-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARA",
        "first_name": "VIRGIL",
        "middle_name": "SALOMON",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yeranuhi Mary Mansourian
• Rexford Manuel
• Yenisel Manuel Manuel, BT
• Arpine Manukyan
• Victoria Manzo
• Vanessa Patricia Maravilla-Gutierrez
• Drew Marchese, RD
• Haley Marcus
• Marina Marcus, MPH, MS
• Erica Mardones

• General Practice Dentistry in Culver City, CA
• Providers in Culver City, 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 Jul 8, 2007; 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.