Individual provider Active NPI

Maria Jose Mucino Escobedo

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1295522183
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
110904 Issued in CA
Practice address
9840 Carmel Mountain Rd
San Diego, CA 92129-2812
Phone
(858) 240-9953
NPI assigned
Apr 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 110904 CA Primary

Addresses

Primary practice location

9840 Carmel Mountain Rd
San Diego, CA 92129-2812

Mailing address

1445 Town Center Dr Apt 1442
Chula Vista, CA 91915-4233
Phone (619) 513-4097

Other practice location 1

640 W Mission Ave
Escondido, CA 92025-1611
Phone (442) 273-2325

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

LicenseStateTypeSpecialty
110904CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Yige Zhao Dental Corporation General Practice CurrentSince Apr 27, 2025 Accepting new patients
Escondido Modern Dentistry, Inc General Practice PastSince Dec 8, 2024 Accepting new patients
Dentists of Port Charlotte, PA PastSince Apr 27, 2025 Accepting new patients

Locations

9840 Carmel Mountain Rd
San Diego, CA 92129
Phone (858) 240-9953

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1295522183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 TOWN CENTER DR APT 1442",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919154233",
            "telephone_number": "619-513-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9840 CARMEL MOUNTAIN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292812",
            "telephone_number": "858-240-9953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 W Mission Ave",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920251611",
            "country_code": "US",
            "telephone_number": "442-273-2325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUCINO ESCOBEDO",
        "first_name": "MARIA JOSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110904",
            "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 Apr 23, 2025; 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.