Active NPI
Maylene Luc, DDS
- Dentist
- West Sacramento, CA
National Provider Identifier
1194840017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 51569
- Practice address
- 1035 Jefferson Blvd
Ste. 7
West Sacramento, CA 95691-3343 - Phone
- (916) 371-9051
- Fax
- (916) 371-9095
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 51569 | CA | Primary |
Addresses
Primary practice location
1035 Jefferson Blvd
Ste. 7
West Sacramento, CA 95691-3343
Mailing address
1035 Jefferson Blvd
Ste. 7
West Sacramento, CA 95691-3343
Phone (916) 371-9051
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 |
|---|---|---|---|
| 51569 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233792000000",
"number": "1194840017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1035 JEFFERSON BLVD",
"address_2": "STE. 7",
"city": "WEST SACRAMENTO",
"state": "CA",
"postal_code": "956913343",
"telephone_number": "916-371-9051",
"fax_number": "916-371-9095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 JEFFERSON BLVD",
"address_2": "STE. 7",
"city": "WEST SACRAMENTO",
"state": "CA",
"postal_code": "956913343",
"telephone_number": "916-371-9051",
"fax_number": "916-371-9095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUC",
"first_name": "MAYLENE",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2009-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "51569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.