NPIMap

Organization Active NPI

Dr. Jack Ma, DDS, Inc.

Doing business as Dr. Tooth Family Dentistry

  • General Practice Dentistry
  • Temple City, CA
National Provider Identifier
1457407512
Registry record updated Apr 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
40666 Issued in CA
Legal business name
DR. JACK MA, DDS, INC.
Doing business as
Dr. Tooth Family Dentistry
Practice address
9093 Las Tunas Dr
Temple City, CA 91780-1901
Phone
(626) 286-1568
Fax
(626) 286-9738
NPI assigned
Jan 25, 2007
Last updated
Apr 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2016

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

Authorized official

Name
Dr. Jack T. Ma, D.D.S.NPI 1386814424
Title
Dentist
Phone
(626) 286-1568

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 40666 CA Primary

Addresses

Primary practice location

9093 Las Tunas Dr
Temple City, CA 91780-1901

Mailing address

9093 Las Tunas Dr
Temple City, CA 91780-1901
Phone (626) 286-1568

Other identifiers 1

IdentifierTypeStateIssuer
B40666-01OtherCADENTI-CAL PROVIDER ID

Other names 1

  • Dr. Tooth Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

9093 Las Tunas Dr
Temple City, CA 91780
Phone (626) 286-1568

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461888000000",
    "number": "1457407512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9093 LAS TUNAS DR",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917801901",
            "telephone_number": "626-286-1568",
            "fax_number": "626-286-9738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9093 LAS TUNAS DR",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917801901",
            "telephone_number": "626-286-1568",
            "fax_number": "626-286-9738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JACK MA, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2016-04-29",
        "status": "A",
        "authorized_official_last_name": "MA",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "626-286-1568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL PROVIDER ID",
            "identifier": "B40666-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Tooth Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Temple City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.