Active NPI
Mackenzie Porter
- Dentist
- Oxnard, CA
National Provider Identifier
1235546664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 65067
- Practice address
- 1920 Outlet Center Dr
Oxnard, CA 93036-0677 - Phone
- (702) 671-5134
- NPI assigned
- Jul 17, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | LL-377-14 | NV | |
| Dentist | 122300000X | 65067 | CA | Primary |
Addresses
Primary practice location
1920 Outlet Center Dr
Oxnard, CA 93036-0677
Mailing address
41 Mahogany LN
Simi Valley, CA 93065-6922
Phone (775) 230-5461
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 |
|---|---|---|---|
| 65067 | CA | MD | Clinical Social Worker |
| LL-377-14 | NV | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444953600000",
"number": "1235546664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 MAHOGANY LN",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930656922",
"telephone_number": "775-230-5461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1920 OUTLET CENTER DR",
"city": "OXNARD",
"state": "CA",
"postal_code": "930360677",
"telephone_number": "702-671-5134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "MACKENZIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-17",
"last_updated": "2015-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "LL-377-14",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "65067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oxnard, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.