Su Ping Mai, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61517 Issued in KS

Practice address

36000 Darnall Loop
Fort Hood, TX 76544-5095

Phone

(254) 287-2705

NPI assigned

Aug 2, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9743/brand/1/csg/1/fhir/r4

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

• The Davis Street Community Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • San Leandro, CA
  • NPI 1215358924
  Medicare reassignment NPD
• Su Ping Mai DMD Inc

  • Dental Clinic/Center
  • San Leandro, CA
  • NPI 1770303380
  NPD Authorized official

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1629592456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36000 DARNALL LOOP",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765445095",
            "telephone_number": "254-287-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 DARNALL LOOP",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765445095",
            "telephone_number": "254-287-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAI",
        "first_name": "SU PING",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-02",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "61517",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "101759",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lester Everton Mack
• Robert Anthony Madden Jr., M.D.
• Patrice Maddox
• Sapna Madia
• Moon Ho Maeng, RPH
• Patrick James Malafronte, MD
• Crystal Malone, LVN
• Laura Kathleen Malone, RD, LD
• Corazon L Mamaril
• Jacqueline Rose Mancillas

• General Practice Dentistry in Fort Hood, TX
• Providers in Fort Hood, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.

Verify at the official NPI Registry.