Marc Dentico-Olin DMD MD Inc

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

MARC DENTICO-OLIN DMD MD INC

Practice address

2878 Camino del Rio S Ste 210
San Diego, CA 92108-3845

Phone

(619) 298-2200

Fax

(619) 295-6776

NPI assigned

Jul 29, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Marc Dentico-Olin, DMD, MDNPI 1629205174

Title

Surgeon

Phone

(914) 960-3826

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marc Dentico-Olin, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • San Diego, CA
  • NPI 1629205174
  NPD Authorized official

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772755200000",
    "number": "1376152934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2878 CAMINO DEL RIO S STE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083845",
            "telephone_number": "619-298-2200",
            "fax_number": "619-295-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2878 CAMINO DEL RIO S STE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083845",
            "telephone_number": "619-298-2200",
            "fax_number": "619-295-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC DENTICO-OLIN DMD MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-29",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A",
        "authorized_official_last_name": "DENTICO-OLIN",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "914-960-3826",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@mvporalsurgery.com",
            "affiliation": "N",
            "endpointDescription": "main office email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2878 Camino Del Rio S Ste 210",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921083845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• S. Mohammad Marashi, M.D.
• Julie Christine Marazzo, DPT
• Bonnie Marblestone
• Taja Reniece Marbley
• Riolan Marbun, O.D.
• Marc Gehr M.D.
• Krishelle Leong Marc-Aurele, MD
• Maria C Marcano
• Marcel T. Bougher, DDS, Inc
• Adrianna Marceleno Ochoa

• Oral and Maxillofacial Surgery (Dentist) in San Diego, CA
• Providers in San Diego, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.