NPIMap

Organization Active NPI

Marina Dental

  • Exclusive Provider Organization
  • Oxnard, CA
National Provider Identifier
1265573505
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
37429 Issued in CA
Legal business name
MARINA DENTAL
Practice address
3611 W 5TH St
Ste a
Oxnard, CA 93030-6436
Phone
(805) 985-1800
Fax
(805) 984-0598
NPI assigned
Feb 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Keith Alan Johnson, D.D.S.
Title
Owner
Phone
(805) 985-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 37429 CA Primary

Addresses

Primary practice location

3611 W 5TH St
Ste a
Oxnard, CA 93030-6436

Mailing address

3611 W 5TH St
Ste a
Oxnard, CA 93030-6436
Phone (805) 985-1800

Other names 1

  • Keith A. Johnson D.D.S. Other name

National Provider Directory

National Provider Directory

Locations

3611 W 5th St
Ste A
Oxnard, CA 93030
Phone (805) 985-1800

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265573505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 W 5TH ST",
            "address_2": "STE A",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930306436",
            "telephone_number": "805-985-1800",
            "fax_number": "805-984-0598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 W 5TH ST",
            "address_2": "STE A",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930306436",
            "telephone_number": "805-985-1800",
            "fax_number": "805-984-0598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-985-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "37429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keith A. Johnson D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 22, 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.