Maryjean Tripon Rabadam, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

36822 Issued in CA

Practice address

9170 Elkgrove -Florin Rd.
Suite D
Elkgrove, CA 95624

Phone

(916) 686-2888

Fax

(916) 405-3436

NPI assigned

Mar 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295859320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9170 ELKGROVE -FLORIN RD.",
            "address_2": "SUITE D",
            "city": "ELKGROVE",
            "state": "CA",
            "postal_code": "95624",
            "telephone_number": "916-686-2888",
            "fax_number": "916-405-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9170 ELKGROVE -FLORIN RD.",
            "address_2": "SUITE D",
            "city": "ELKGROVE",
            "state": "CA",
            "postal_code": "95624",
            "telephone_number": "916-686-2888",
            "fax_number": "916-405-3436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABADAM",
        "first_name": "MARYJEAN",
        "middle_name": "TRIPON",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Santiago Quintero Ochoa
• Laurencia Quintero
• Zoe Quittner
• Soha Qureshi
• R&R Physical Medicine and Rehabilitation Medical Clinic, Inc
• Victor Rabe
• Rad Home Care LLC
• Samya Radcliffe
• Shevonne Marie Radich, MA., MFT
• Radiological Associates of Sacramento Medical Group

• General Practice Dentistry in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.