Individual provider Active NPI

Maria Consuelo Lipumano Sobrepena, D.M.D.

  • General Practice Dentistry
  • Fremont, CA
National Provider Identifier
1366431736
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
36434 Issued in CA
Practice address
3683 Thornton Ave
Fremont, CA 94536-7423
Phone
(510) 794-7401
Fax
(510) 794-8957
NPI assigned
Oct 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 36434 CA Primary

Addresses

Primary practice location

3683 Thornton Ave
Fremont, CA 94536-7423

Mailing address

3683 Thornton Ave
Fremont, CA 94536-7423
Phone (510) 794-7401

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
36434CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366431736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3683 THORNTON AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945367423",
            "telephone_number": "510-794-7401",
            "fax_number": "510-794-8957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3683 THORNTON AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945367423",
            "telephone_number": "510-794-7401",
            "fax_number": "510-794-8957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBREPENA",
        "first_name": "MARIA CONSUELO",
        "middle_name": "LIPUMANO",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.