Active NPI
Maria Ahleen De Leon Medina, DMD
- Dentist
- Grass Valley, CA
National Provider Identifier
1508206657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 64333
- Practice address
- 1350 E Main St
Grass Valley, CA 95945-5208 - Phone
- (530) 477-8545
- NPI assigned
- Jul 2, 2013
- 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 | 64333 | CA | Primary |
Addresses
Primary practice location
1350 E Main St
Grass Valley, CA 95945-5208
Mailing address
7698 San Simeon Dr
Citrus Heights, CA 95610-5736
Phone (916) 276-6942
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423008000000",
"number": "1508206657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7698 SAN SIMEON DR",
"city": "CITRUS HEIGHTS",
"state": "CA",
"postal_code": "956105736",
"telephone_number": "916-276-6942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 E MAIN ST",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959455208",
"telephone_number": "530-477-8545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "MARIA AHLEEN",
"middle_name": "DE LEON",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-02",
"last_updated": "2015-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "64333",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grass Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.