Active NPI
Marina Wasche, D.D.S.
- Dentist
- San Jose, CA
National Provider Identifier
1417284746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 53834
- Practice address
- 500 Tully Rd
2ND Floor Dental Clinic
San Jose, CA 95111-1917 - Phone
- (408) 817-1461
- NPI assigned
- Nov 6, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 53834 | CA | Primary |
Addresses
Primary practice location
500 Tully Rd
2ND Floor Dental Clinic
San Jose, CA 95111-1917
Mailing address
500 Tully Rd
2ND Floor Dental Clinic
San Jose, CA 95111-1917
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
| License | State | Type | Specialty |
|---|---|---|---|
| 53834 | CA | MD | Marriage & Family Therapist |
Interoperability endpoints
- mwasche11716@santaclaravalley.direct-ci.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257465600000",
"number": "1417284746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 TULLY RD",
"address_2": "2ND FLOOR DENTAL CLINIC",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951111917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 TULLY RD",
"address_2": "2ND FLOOR DENTAL CLINIC",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951111917",
"telephone_number": "408-817-1461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASCHE",
"first_name": "MARINA",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-06",
"last_updated": "2009-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "53834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.