NPIMap

Organization Active NPI

M a C T Health Board, Incorporated

Doing business as MACT Dental, Mariposa

  • Federally Qualified Health Center (FQHC)
  • Mariposa, CA
National Provider Identifier
1497447916
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
M A C T HEALTH BOARD, INCORPORATED
Doing business as
MACT Dental, Mariposa
Practice address
5204 Hospital Rd
Mariposa, CA 95338-9524
Phone
(209) 966-0573
Fax
(209) 742-6321
NPI assigned
May 23, 2023
Last updated
Jun 12, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
M A C T HEALTH BOARD, INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Authorized official

Name
John Shawver Alexander
Title
Executive Director
Phone
(209) 754-6258

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

5204 Hospital Rd
Mariposa, CA 95338-9524

Mailing address

PO Box 939
Angels Camp, CA 95222-0939
Phone (209) 754-6262

Other identifiers 1

IdentifierTypeStateIssuer
1366519431OtherCAGROUP NPI

Other names 1

  • MACT Dental, Mariposa Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2216013Mact Dental, Mariposa5204 Hospital Road, Mariposa, CA 95338Certificate of waiverMar 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Mact Health Board Incorporated13 organizations share this tax ID, including this one
Part of
Mact Health Board Incorporated

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

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": "1684800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1497447916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 939",
            "city": "ANGELS CAMP",
            "state": "CA",
            "postal_code": "952220939",
            "telephone_number": "209-754-6262",
            "fax_number": "209-754-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5204 HOSPITAL RD",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953389524",
            "telephone_number": "209-966-0573",
            "fax_number": "209-742-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M A C T HEALTH BOARD, INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "M A C T HEALTH BOARD, INCORPORATED",
        "enumeration_date": "2023-05-23",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "SHAWVER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "209-754-6258"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1366519431",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MACT Dental, Mariposa",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MACT Dental, Mariposa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mariposa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.