Marcio A Dafonseca, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

71000193 Issued in OH

Practice address

555 S. 18TH Street
Columbus, OH 43205

Phone

(614) 722-4579

Fax

(614) 722-4565

NPI assigned

Oct 2, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Regents of the University of Michigan Dental Faculty Associates

  • General Practice Dentistry
  • Ann Arbor, MI
  • NPI 1932279882

  Pediatric Dentistry

  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1548353295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S. 18TH STREET",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43205",
            "telephone_number": "614-722-4579",
            "fax_number": "614-722-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S. 18TH STREET",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43205",
            "telephone_number": "614-722-4579",
            "fax_number": "614-722-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAFONSECA",
        "first_name": "MARCIO",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "71000193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0243972",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne Daddah
• Nahid Dadmehr, M.D.
• Spencer Dadson-Kwofie, NP
• Ivana Dadzie
• Daffodill Inc
• Erica Starr Daft, RN
• Jeannette Chary Dagam, DO
• Edward Scott Dagenfield, LICDC, LPC
• Derrick Daggett, LPC
• Laxmi Narayan Dahal, QMHS 3YRS CMS

• Pediatric Dentistry in Columbus, OH
• Providers in Columbus, OH by specialty
• Pediatric Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.