Organization Active NPI

Marilou Mercado-Ulit,D.D.S. Inc.

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1508269598
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MARILOU MERCADO-ULIT,D.D.S. INC.
Practice address
2105 Beverly Blvd Ste 125
Suite# 125
Los Angeles, CA 90057-2260
Phone
(213) 413-8766
NPI assigned
Oct 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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

Authorized official

Name
Marilou Mercado- Ulit, D.D.S.NPI 1972679603
Title
Dentist/Owner
Phone
(213) 413-8766

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

2105 Beverly Blvd Ste 125
Suite# 125
Los Angeles, CA 90057-2260

Mailing address

2105 Beverly Blvd Ste 125
Suite# 125
Los Angeles, CA 90057-2260
Phone (213) 413-8766

Other identifiers 6

IdentifierTypeStateIssuer
G90642-01OtherCADELTA DENTAL/MEDICAL
1972679603MedicaidCA
1972679603OtherCADENTI-CAL
1972679603OtherCAMEDICAL/DENTICAL
1972679603OtherCADENTICAL/MEDICAL
122300000XMedicaidCA

National Provider Directory

National Provider Directory

Locations

2105 Beverly Blvd
Ste 125
Los Angeles, CA 90057
Phone (213) 413-8765

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412294400000",
    "number": "1508269598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 BEVERLY BLVD STE 125",
            "address_2": "SUITE# 125",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572260",
            "telephone_number": "213-413-8766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 BEVERLY BLVD STE 125",
            "address_2": "SUITE# 125",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572260",
            "telephone_number": "213-413-8766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILOU MERCADO-ULIT,D.D.S. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-03",
        "last_updated": "2014-10-03",
        "status": "A",
        "authorized_official_last_name": "ULIT",
        "authorized_official_first_name": "MARILOU",
        "authorized_official_middle_name": "MERCADO-",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "213-413-8766",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL/MEDICAL",
            "identifier": "G90642-01",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972679603",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "1972679603",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL/DENTICAL",
            "identifier": "1972679603",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL/MEDICAL",
            "identifier": "1972679603",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122300000X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.