Active NPI
Cine Marina Paul, DMD
- Dentist
- Balch Springs, TX
National Provider Identifier
1649508656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 25101
- Practice address
- 11203 Lake June Rd Ste 120
Balch Springs, TX 75180-1304 - Phone
- (972) 752-6210
- Fax
- (972) 629-6905
- NPI assigned
- Dec 2, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 14042917 | TX | |
| Dentist | 122300000X | 019028576 | IL | |
| Dentist | 122300000X | 25101 | TX | Primary |
Addresses
Primary practice location
11203 Lake June Rd Ste 120
Balch Springs, TX 75180-1304
Mailing address
909 Tripp Rd # 190
Mesquite, TX 75150-5703
Phone (972) 752-6210
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 |
|---|---|---|---|
| 25101 | TX | MD | Clinical Child & Adolescent Psychologist |
| 019028576 | IL | MD | Dentist |
| 14042917 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JD Mesquite Dental PLLC | Dentist | 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.
-
- Dentist
- Mesquite, TX
- NPI 1922666916
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666742400000",
"number": "1649508656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 TRIPP RD # 190",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751505703",
"telephone_number": "972-752-6210",
"fax_number": "773-565-4065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11203 LAKE JUNE RD STE 120",
"city": "BALCH SPRINGS",
"state": "TX",
"postal_code": "751801304",
"telephone_number": "972-752-6210",
"fax_number": "972-629-6905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAUL",
"first_name": "CINE",
"middle_name": "MARINA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-02",
"last_updated": "2022-10-26",
"certification_date": "2022-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "14042917",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019028576",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "25101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Balch Springs, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.