Active NPI
Marian Daoud Yassa, DDS
- General Practice Dentistry
- Encino, CA
National Provider Identifier
1336399310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 57588
- Practice address
- 16550 Ventura Blvd # 316
Encino, CA 91436-2004 - Phone
- (818) 305-6755
- Fax
- (818) 305-6737
- NPI assigned
- Sep 25, 2008
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 57588 | CA | Primary |
Addresses
Primary practice location
16550 Ventura Blvd # 316
Encino, CA 91436-2004
Mailing address
16550 Ventura Blvd # 316
Encino, CA 91436-2004
Phone (818) 305-6755
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 23, 2015 through Dec 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57588 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364342400000",
"number": "1336399310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16550 VENTURA BLVD # 316",
"city": "ENCINO",
"state": "CA",
"postal_code": "914362004",
"telephone_number": "818-305-6755",
"fax_number": "818-305-6737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16550 VENTURA BLVD # 316",
"city": "ENCINO",
"state": "CA",
"postal_code": "914362004",
"telephone_number": "818-305-6755",
"fax_number": "818-305-6737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YASSA",
"first_name": "MARIAN",
"middle_name": "DAOUD",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-25",
"last_updated": "2013-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "57588",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.