Roberto Amisael Marroquin, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

105890 Issued in CA

Practice address

1708 S Victoria Ave Ste B
Ventura, CA 93003-6595

Phone

(805) 941-1001

NPI assigned

Dec 30, 2020

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

Practice roles

Locations

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.

• Jabaiti Dental Corporation

  • Dental Clinic/Center
  • Ventura, CA
  • NPI 1851930655
  NPD

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1205423720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W 56TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900373624",
            "telephone_number": "323-537-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 S VICTORIA AVE STE B",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930036595",
            "telephone_number": "805-941-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARROQUIN",
        "first_name": "ROBERTO",
        "middle_name": "AMISAEL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manuel Marquez, M.D.
• Meagan Marquez
• Chase Marr
• Albert Marrero
• Anna Luisa Marroquin, PA
• Rebecca Marrs
• Karie Marsh, M.A. CCC-SLP
• Mariah Diana Marsh, DPT
• Shauna Marsh, PSYD
• Brigynda Ananias Marshall, MPH, RD

• Dentist in Ventura, CA
• Providers in Ventura, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.