G. Marquez, D.D.S., Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38716 Issued in CA

Legal business name

G. MARQUEZ, D.D.S., INC

Doing business as

Otay Lakes Smiles

Practice address

2452 Fenton Street
Suite C-200
Chula Vista, CA 91914

Phone

(619) 934-6620

Fax

(619) 934-4503

NPI assigned

Jun 5, 2007

Organization subpart

No

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

Authorized official

Name

Guadalupe Marquez, D.D.S.

Title

President

Phone

(619) 934-6620

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Otay Lakes Smiles Doing business as

Locations

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1407058845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2452 FENTON STREET",
            "address_2": "SUITE C-200",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91914",
            "telephone_number": "619-934-6620",
            "fax_number": "619-934-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2452 FENTON STREET",
            "address_2": "SUITE C-200",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91914",
            "telephone_number": "619-934-6620",
            "fax_number": "619-934-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G. MARQUEZ, D.D.S., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "MARQUEZ",
        "authorized_official_first_name": "GUADALUPE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-934-6620",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "B38716-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Otay Lakes Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Stacia Fuller-Christie, FNP
• Clayton Scott Fuller, D.D.S.
• Erica Funes
• Christina Furnival
• Susanne Karenina Fux Cortes, LMFT
• Francisco Bagsiyao Gabriel, R.N.
• Lyra Katrina Gabriel, PT
• Driss Gaieb, PHARMD
• Nidhi Gajakas, MD
• Ira Galang

• General Practice Dentistry in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; 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.