Active NPI
Mary M Jew, D.D.S.
- Periodontics
- Irvine, CA
National Provider Identifier
1639485303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 35410
- Practice address
- 4980 Barranca Pkwy
Suite 150
Irvine, CA 92604-8645 - Phone
- (949) 689-2282
- NPI assigned
- Aug 19, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 35410 | CA | Primary |
Addresses
Primary practice location
4980 Barranca Pkwy
Suite 150
Irvine, CA 92604-8645
Mailing address
PO Box 15013
Irvine, CA 92623-5013
Phone (949) 689-2282
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35410 | CA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Will M Wong D.D.S. Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Irvine, CA
- NPI 1285768853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422403200000",
"number": "1639485303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 15013",
"city": "IRVINE",
"state": "CA",
"postal_code": "926235013",
"telephone_number": "949-689-2282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4980 BARRANCA PKWY",
"address_2": "SUITE 150",
"city": "IRVINE",
"state": "CA",
"postal_code": "926048645",
"telephone_number": "949-689-2282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEW",
"first_name": "MARY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-19",
"last_updated": "2015-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "35410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
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- Catherine Jeter, PA-C
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- Jewish Family Service of Orange County
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- Dhiraj Jeyanandarajan, M.D.
- Maria Fernanda Jezbera
- Ji Yon Lee MD, Inc (Grace Pediatrics)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.