Active NPI
Macario Dizon Soliman II, DDS
- Dentist
- Venice, CA
National Provider Identifier
1629260450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 55831
- Practice address
- 323 Lincoln Blvd
Venice, CA 90291-2842 - Phone
- (310) 396-5654
- NPI assigned
- Aug 15, 2007
- Sex
- Male
- 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 | 55831 | CA | Primary |
Addresses
Primary practice location
323 Lincoln Blvd
Venice, CA 90291-2842
Mailing address
3360 Sawtelle Blvd Apt 107
Los Angeles, CA 90066-1626
Phone (415) 420-2508
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120711000327 | CA | Order and Referring Only - Oral Surgery | 9335304666 |
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": "1187136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245024000000",
"number": "1629260450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3360 SAWTELLE BLVD APT 107",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900661626",
"telephone_number": "415-420-2508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "323 LINCOLN BLVD",
"city": "VENICE",
"state": "CA",
"postal_code": "902912842",
"telephone_number": "310-396-5654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOLIMAN",
"first_name": "MACARIO",
"middle_name": "DIZON",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-15",
"last_updated": "2009-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "55831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Venice, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; 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.