Mario Jose Cordero-Pangrazio, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

102757 Issued in CA

Practice address

110 Bergen St
Newark, NJ 07103-2495

Phone

(408) 656-5953

NPI assigned

Jul 12, 2018

Last updated

Jul 12, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Mario J Cordero-Pangrazio, DMD, Inc

  • Dental Clinic/Center
  • San Jose, CA
  • NPI 1851019509
  NPD Authorized official

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1548746555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14358 CORDWOOD CT",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950705628",
            "telephone_number": "408-656-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032495",
            "telephone_number": "408-656-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDERO-PANGRAZIO",
        "first_name": "MARIO",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "102757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roger Cooper, MD
• Ebony Copeland
• Beth Faye Coplan, RD
• Nicole Coppin
• Danielle Marie Coppola, ATC
• Cornerstone Care Services LLC (Cornerstone Care Services)
• Cornerstone Counseling Services LLC
• Oriana Ellen Cornett, M.D.
• Denise Corona, PA
• Carlos Jose Coronado Guzman

• Dentist in Newark, NJ
• Providers in Newark, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; 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.