Active NPI
Mary Ann Ebba, DMD
- Dentist
- Glendora, CA
National Provider Identifier
1427115013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 40933
- Practice address
- 836 S Grand Avenue
Glendora, CA 91740-4806 - Phone
- (626) 852-1711
- Fax
- (626) 852-1713
- NPI assigned
- Jan 2, 2007
- 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 | 40933 | CA | Primary |
Addresses
Primary practice location
836 S Grand Avenue
Glendora, CA 91740-4806
Mailing address
836 S Grand Avenue
Glendora, CA 91740-4806
Phone (626) 852-1711
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 |
|---|---|---|---|
| 40933 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427115013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "836 S GRAND AVENUE",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917404806",
"telephone_number": "626-852-1711",
"fax_number": "626-852-1713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "836 S GRAND AVENUE",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917404806",
"telephone_number": "626-852-1711",
"fax_number": "626-852-1713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBBA",
"first_name": "MARY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "40933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendora, CA
- East Valley Emergency Medical Associates, Inc.
- East Valley Glendora Hospital LLC
- East Valley Glendora Hospital LLC
- East Valley Hospital Medical Center
- East Valley Pathology Medical Group
- Anna Lynn Edwards, N.P.
- Edwin Oghoorian, DPM, Inc.
- Stephanie M Eiland, PMHNP
- Mohamed Elzanaty, RN
- Emanate Health Foothill Presbyterian Hospital
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.