Mac Dental Corporation

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

45585 Issued in CA

Legal business name

MAC DENTAL CORPORATION

Practice address

9855 Erma Road, #110
Scripps Periodontics
San Diego, CA 92131

Phone

(240) 383-7623

NPI assigned

Oct 11, 2017

Organization subpart

Yes

Parent organization

MAC DENTAL GROUPAs reported in NPPES

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

Authorized official

Name

Dr. Frank Mac, DDS

Title

Owner/President

Phone

(240) 383-7623

Specialties & licenses 1

Addresses

Part of

Mac Dental Corporation

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509408000000",
    "number": "1235649690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8534 HOPSEED LANE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92129",
            "telephone_number": "240-383-7623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9855 ERMA ROAD, #110",
            "address_2": "SCRIPPS PERIODONTICS",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92131",
            "telephone_number": "240-383-7623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAC DENTAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAC DENTAL GROUP",
        "enumeration_date": "2017-10-11",
        "last_updated": "2017-10-31",
        "status": "A",
        "authorized_official_last_name": "MAC",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "240-383-7623",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "45585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aleah Morgan Maas
• Froilan Mabalo, RN
• Matthew Gabriel Mabanta
• Arthur Ray Mabaquiao, M.D.
• Ahmed Mabrouk
• Mac, Maksim and Yang Dental Partnership a General Partnership
• Mindy Mac
• Truc Mac
• Kevin Macabasco, BCBA
• Malia Macabitas

• Oral & Maxillofacial Surgery (D.M.D.) in San Diego, CA
• Providers in San Diego, CA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; 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.