NPIMap

Organization Active NPI

Jonathan L Maddatu DDS Inc

  • General Practice Dentistry
  • Van Nuys, CA
National Provider Identifier
1265696173
Registry record updated Oct 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
55562 Issued in CA
Legal business name
JONATHAN L MADDATU DDS INC
Practice address
6736 N. Sepulveda Blvd
Van Nuys, CA 91411-3306
Phone
(818) 786-8803
Fax
(818) 786-8570
NPI assigned
Jul 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2009

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

Authorized official

Name
Dr. Jonathan Lorenzo Maddatu, DDS
Title
Dentist
Phone
(818) 786-8803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 55562 CA Primary

Addresses

Primary practice location

6736 N. Sepulveda Blvd
Van Nuys, CA 91411-3306

Mailing address

6736 N. Sepulveda Blvd
Van Nuys, CA 91411
Phone (818) 786-8803

National Provider Directory

National Provider Directory

Locations

6736 Sepulveda Blvd
Van Nuys, CA 91411
Phone (818) 786-8803

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256169600000",
    "number": "1265696173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6736 N. SEPULVEDA BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "91411",
            "telephone_number": "818-786-8803",
            "fax_number": "818-786-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6736 N. SEPULVEDA BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914113306",
            "telephone_number": "818-786-8803",
            "fax_number": "818-786-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN L MADDATU DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-10",
        "last_updated": "2009-10-22",
        "status": "A",
        "authorized_official_last_name": "MADDATU",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "LORENZO",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "818-786-8803",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; 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.