Individual provider Active NPI

Christine Marcelo, DDS

  • Pediatric Dentistry
  • Pasadena, CA
National Provider Identifier
1134421985
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
59420 Issued in CA
Practice address
840 E Green St
Unit 131
Pasadena, CA 91101-5427
Phone
(818) 642-5272
NPI assigned
Nov 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 59420 CA Primary

Addresses

Primary practice location

840 E Green St
Unit 131
Pasadena, CA 91101-5427

Mailing address

840 E Green St
Unit 131
Pasadena, CA 91101-5427

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150923000500 CA Order and Referring Only - DentistPractitioner - Dentist 4486961489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Christine Marcelo Aquino DDS Pediatric Dentistry CurrentSince Mar 20, 2025 Accepting new patients

Locations

70 S Lake Ave
Ste 1050
Pasadena, CA 91101
Phone (818) 642-5272

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": "1291075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291075200000",
    "number": "1134421985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 E GREEN ST",
            "address_2": "UNIT 131",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911015427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 E GREEN ST",
            "address_2": "UNIT 131",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911015427",
            "telephone_number": "818-642-5272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELO",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-30",
        "last_updated": "2010-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "59420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.