Individual provider Active NPI

Maria Jaimes, RDAEF2

  • Dental Assistant
  • La Quinta, CA
National Provider Identifier
1205685765
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
AEF1330 Issued in CA
Practice address
79800 Highway 111 Ste 109
La Quinta, CA 92253-6003
Phone
(951) 250-8121
NPI assigned
May 16, 2024
Last updated
May 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X RDA62866 CA
Dental Assistant 126800000X AEF1330 CA Primary

Addresses

Primary practice location

79800 Highway 111 Ste 109
La Quinta, CA 92253-6003

Mailing address

13390 Larkhaven Dr
Moreno Valley, CA 92553-3205
Phone (951) 250-8121

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
AEF1330CAMDDental Assistant
RDA62866CAMDDental Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Dental Group of Dr Kristina Fernandez Corp CurrentSince May 19, 2024 Accepting new patients

Locations

79800 Highway 111
Ste 109
La Quinta, CA 92253
Phone (760) 775-0600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1205685765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13390 LARKHAVEN DR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533205",
            "telephone_number": "951-250-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79800 HIGHWAY 111 STE 109",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922536003",
            "telephone_number": "951-250-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIMES",
        "first_name": "MARIA",
        "credential": "RDAEF2",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "CA",
            "license": "RDA62866",
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "CA",
            "license": "AEF1330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Quinta, CA

Sources for this page

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