Fitzpatrick ,Mary,DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

39633 Issued in CA

Legal business name

FITZPATRICK ,MARY,DDS INC

Doing business as

mchenry village dental services

Practice address

1601 McHenry Village Way
Ste 10-a
Modesto, CA 95350-4307

Phone

(209) 527-5727

Fax

(209) 527-4626

NPI assigned

Feb 21, 2008

Last updated

Feb 21, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mary Lou FitzpatrickNPI 1811065527

Title

Owner

Phone

(209) 527-4631

Specialties & licenses 1

Addresses

Other names 1

• mchenry village dental services Doing business as

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.

• Mary Lou Fitzpatrick, DDS

  • General Practice Dentistry
  • Modesto, CA
  • NPI 1811065527
  NPD (past) Authorized official

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1386813509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 MCHENRY VILLAGE WAY",
            "address_2": "STE 10-A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504307",
            "telephone_number": "209-527-5727",
            "fax_number": "209-527-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 MCHENRY VILLAGE WAY",
            "address_2": "STE 10-A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504307",
            "telephone_number": "209-527-5727",
            "fax_number": "209-527-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITZPATRICK ,MARY,DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "FITZPATRICK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "LOU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-527-4631",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "39633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "mchenry village dental services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew Turnbull Fithian
• Curtis Fitzgerald, CPO
• Ian Timothy Fitzgerald, PA-C
• John Fitzgerald
• Michelle Don Fitzgerald
• Dale Walter Fitzpatrick, MD
• Mary Lou Fitzpatrick, DDS
• Michael Edward Fitzpatrick, M.D.
• Five Leaf Colver Trucking LLC
• Kristen E. Flack, AGNP

• Dentist in Modesto, CA
• Providers in Modesto, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.