Active NPI
Mary Jane De Leon Salapong, RDA
- Dental Assistant
- Norco, CA
National Provider Identifier
1447748199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- RDA58343
- Practice address
- 2440 River Rd Ste 140
Norco, CA 92860-2402 - Phone
- (888) 904-3204
- NPI assigned
- Apr 27, 2018
- 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 |
|---|---|---|---|---|
| Dental Assistant | 126800000X | RDA58343 | CA | Primary |
Addresses
Primary practice location
2440 River Rd Ste 140
Norco, CA 92860-2402
Mailing address
34094 Lady Fern CT
Lake Elsinore, CA 92532-2940
Phone (949) 483-0369
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RDA58343 | Medicaid | CA |
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 |
|---|---|---|---|
| RDA58343 | CA | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524787200000",
"number": "1447748199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34094 LADY FERN CT",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925322940",
"telephone_number": "949-483-0369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2440 RIVER RD STE 140",
"city": "NORCO",
"state": "CA",
"postal_code": "928602402",
"telephone_number": "888-904-3204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALAPONG",
"first_name": "MARY JANE",
"middle_name": "DE LEON",
"name_prefix": "Mrs.",
"credential": "RDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-27",
"last_updated": "2018-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CA",
"license": "RDA58343",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RDA58343",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.