Kaitlin Niki Maroon

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

108590 Issued in CA

Practice address

310 Third Ave Ste C1B
Chula Vista, CA 91910-3954

Phone

(619) 476-1600

Fax

(619) 476-1600

NPI assigned

Mar 28, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• John Maroon DDS a Professional Corporation

  • General Practice Dentistry
  • Chula Vista, CA
  • NPI 1740405612
  NPD (past)

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1447954151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 THIRD AVE STE C1B",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103954",
            "telephone_number": "619-476-1600",
            "fax_number": "619-476-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 THIRD AVE STE C1B",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103954",
            "telephone_number": "619-476-1600",
            "fax_number": "619-476-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAROON",
        "first_name": "KAITLIN",
        "middle_name": "NIKI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "108590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Denise Maroon-Lopez, DDS
• Brandon Kian Gino Maroon, DDS
• Ileana Dominique Maroon, DDS
• Ileana P Maroon, D.D.S
• John Maroon, DDS
• Robert Edward Maroon, D.D.S.,F.I.C.O.I
• Marque Medical Clinic, Inc
• Marque Medical Clinic, Inc.
• Marquez Dental Inc
• Alejandra Sofia Marquez Moreno, LMFT

• 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 Mar 28, 2023; 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.