Individual provider Active NPI

Amabelle Shayeghi Marquez, DMD

  • Dentist
  • Fresno, CA
National Provider Identifier
1538645353
Registry record updated Feb 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
102764 Issued in CA
Practice address
3636 N 1St St Ste 152
Fresno, CA 93726-6818
Phone
(559) 229-4536
NPI assigned
Jul 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 102764 CA Primary

Addresses

Primary practice location

3636 N 1St St Ste 152
Fresno, CA 93726-6818

Mailing address

2073 E Fox Glen Dr
Fresno, CA 93730-4798
Phone (559) 304-9689

Other practice location 1

620 W Yosemite Ave
Madera, CA 93637-4523
Phone (559) 673-7701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
102764CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1531612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613260800000",
    "number": "1538645353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2073 E FOX GLEN DR",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937304798",
            "telephone_number": "559-304-9689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 N 1ST ST STE 152",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937266818",
            "telephone_number": "559-229-4536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 W Yosemite Ave",
            "address_purpose": "LOCATION",
            "city": "Madera",
            "state": "CA",
            "postal_code": "936374523",
            "country_code": "US",
            "telephone_number": "559-673-7701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAYEGHI MARQUEZ",
        "first_name": "AMABELLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-15",
        "last_updated": "2021-02-14",
        "certification_date": "2021-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "102764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2021; 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.