Active NPI
Mary Ann Sanvictores, DDS
- Dentist
- San Diego, CA
National Provider Identifier
1275977514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 44360
- Practice address
- 4305 University Ave Ste 120
San Diego, CA 92105-1645 - Phone
- (619) 285-8135
- Fax
- (619) 795-3743
- NPI assigned
- Apr 17, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 44360 | CA | Primary |
Addresses
Primary practice location
4305 University Ave Ste 120
San Diego, CA 92105-1645
Mailing address
2835 Highland Ave
Suite a
National City, CA 91950-7404
Phone (619) 474-5567
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44360 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695686400000",
"number": "1275977514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2835 HIGHLAND AVE",
"address_2": "SUITE A",
"city": "NATIONAL CITY",
"state": "CA",
"postal_code": "919507404",
"telephone_number": "619-474-5567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4305 UNIVERSITY AVE STE 120",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921051645",
"telephone_number": "619-285-8135",
"fax_number": "619-795-3743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANVICTORES",
"first_name": "MARY ANN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-17",
"last_updated": "2023-09-26",
"certification_date": "2023-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "44360",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.