Loan Sam Mao-Patel, D.D.S

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

50054287 Issued in NY

Practice address

470 Patchogue Holbrook Rd
Holbrook, NY 11741-1625

Phone

(631) 589-8485

NPI assigned

Jul 10, 2008

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

Other names 1

• Dr. Loan Sam Mao Professional name

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": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1295999043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 PATCHOGUE HOLBROOK RD",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411625",
            "telephone_number": "631-589-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 PATCHOGUE HOLBROOK RD",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411625",
            "telephone_number": "631-589-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAO-PATEL",
        "first_name": "LOAN",
        "middle_name": "SAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "50054287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOAN",
            "last_name": "MAO",
            "middle_name": "SAM",
            "prefix": "DR.",
            "credential": "D.D.S",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jennifer Malycky, LPN
• Ragi Mamistvalov, OD
• Carol Elaine Mandarino, LCSW CASAC
• Sara Alyssa Manetta
• Sarah Katherine Manger, LPN
• Joy Mariano
• Devin Marino, PT, DPT
• Mary T. Marino, PHD
• Cheryl D Martin, REGISTERED NURSE
• Annamaria B Martinez, BSN

• Pediatric Dentistry in Holbrook, NY
• Providers in Holbrook, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.