Active NPI
Maria Patrocinio De Leon, D.D.S.
- General Practice Dentistry
- Costa Mesa, CA
National Provider Identifier
1376601211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 45240
- Practice address
- 1942 Harbor Blvd
Costa Mesa, CA 92627-2669 - Phone
- (949) 631-1000
- Fax
- (949) 631-0350
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 45240 | CA | Primary |
Addresses
Primary practice location
1942 Harbor Blvd
Costa Mesa, CA 92627-2669
Mailing address
1942 Harbor Blvd
Costa Mesa, CA 92627-2669
Phone (949) 631-1000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1879369 | Other | UNITED CONCORDIA | |
| G-94004-01 | Other | CA | DENTICAL |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| De Leon Dentistry General & Cosmestic | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Costa Mesa, CA
- NPI 1548642846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1376601211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1942 HARBOR BLVD",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926272669",
"telephone_number": "949-631-1000",
"fax_number": "949-631-0350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1942 HARBOR BLVD",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926272669",
"telephone_number": "949-631-1000",
"fax_number": "949-631-0350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LEON",
"first_name": "MARIA",
"middle_name": "PATROCINIO",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "45240",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "1879369",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTICAL",
"identifier": "G-94004-01",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.