Jennifer NA T Mai, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

103147 Issued in CA

Practice address

15422 Crenshaw Blvd
Gardena, CA 90249-4524

Phone

(310) 352-4939

NPI assigned

Sep 13, 2018

Last updated

Jan 28, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Practice roles

Locations

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.

• Mai and Lee Dental Corporation

  • General Practice Dentistry
  • Gardena, CA
  • NPI 1104423177
  NPD
• La-Pham and Kansagra Dental Corporation

  dba Bixby Knolls Modern Dentistry Dental Group

  • Dentist
  • Long Beach, CA
  • NPI 1336675800
  NPD (past)
• Ly Dental Corporation

  dba Dr. Ly Vina Dental Group

  • General Practice Dentistry
  • Westminster, CA
  • NPI 1720495849
  NPD (past)

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1649753849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18803 ROSELLE AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045616",
            "telephone_number": "310-347-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15422 CRENSHAW BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902494524",
            "telephone_number": "310-352-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAI",
        "first_name": "JENNIFER NA",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magnet Medical Supply Inc.
• Emad Eldin Mahmoud
• Brandy Mahoney
• Madison Mahoney
• Mai and Lee Dental Corporation
• Breanne Mailhot, BCBA
• Luis Maimoni
• Nikita Mainaly, PHARMD
• Making Fit Fun, Inc.
• Sunny Makolo

• General Practice Dentistry in Gardena, CA
• Providers in Gardena, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.