Jose Manuel Mariscal, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.027908 Issued in IL

Practice address

7124 W Diversey Ave
Chicago, IL 60707-1601

Phone

(773) 237-8855

NPI assigned

May 20, 2009

Sex

Male

Sole proprietor

No

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• F L M Dental Corp PC

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1235209727
  NPD (past) Authorized official
• Brian M Caraba DDS PC

  • Dentist
  • Chicago, IL
  • NPI 1386864411
  NPD (past)

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242777600000",
    "number": "1306071295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7124 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607071601",
            "telephone_number": "773-237-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7124 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607071601",
            "telephone_number": "773-237-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARISCAL",
        "first_name": "JOSE",
        "middle_name": "MANUEL",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-20",
        "last_updated": "2009-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.027908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariel Marion, MSW
• Brian Marion, D.C., A.R.T.
• Emily Marion, LCSW
• Margaret Marion, LCSW
• Marisa Aguila-Manalo, M.D.
• Melissa Mariscal, MD
• Antoine Marison, CADC
• Maritza Lopez Campos PLLC
• Mariya Manova DMD, P.C.
• Mariya Manova DMD. P.C.

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.