Individual provider Active NPI

Marissa Nicole Saldana Belardinelli, DDS

  • General Practice Dentistry
  • Fresno, CA
National Provider Identifier
1164092292
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
106369 Issued in CA
Practice address
2747 W Bullard Ave Ste 103
Fresno, CA 93711-2279
Phone
(559) 436-8288
NPI assigned
Jun 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 106369 CA Primary

Addresses

Primary practice location

2747 W Bullard Ave Ste 103
Fresno, CA 93711-2279

Mailing address

3454 Del Dios Ave
Clovis, CA 93619-7247
Phone (559) 274-5189

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

LicenseStateTypeSpecialty
106369CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1164092292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3454 DEL DIOS AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936197247",
            "telephone_number": "559-274-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2747 W BULLARD AVE STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112279",
            "telephone_number": "559-436-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELARDINELLI",
        "first_name": "MARISSA",
        "middle_name": "NICOLE SALDANA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.