Marvin E. Ota, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28214 Issued in CA

Legal business name

MARVIN E. OTA, DDS

Practice address

11834 Bryant St
Suite 103
Yucaipa, CA 92399-3815

Phone

(909) 797-8090

NPI assigned

May 31, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Marvin Eiji Ota, D.D.S.NPI 1871675165

Title

Owner

Phone

(909) 797-8090

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marvin Eiji Ota, D.D.S.

  • General Practice Dentistry
  • Yucaipa, CA
  • NPI 1871675165
  NPD (past) Authorized official

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

{
    "created_epoch": "1243728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243728000000",
    "number": "1699901082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11834 BRYANT ST",
            "address_2": "SUITE 103",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923993815",
            "telephone_number": "909-797-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11834 BRYANT ST",
            "address_2": "SUITE 103",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923993815",
            "telephone_number": "909-797-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARVIN E. OTA, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-31",
        "last_updated": "2009-05-31",
        "status": "A",
        "authorized_official_last_name": "OTA",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "EIJI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-797-8090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B28214-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gladys Martinez
• Isabella Rosa Martinez
• Jaime Martinez, PPS
• Veronica M Martinez
• Molly Martonik, M.S., CCC-SLP
• Kendra Mason, M.S., ATC
• Odette Matar
• Mauricio Dossantos DDS
• Mauricio Dossantos DDS Inc.
• Nariba Maycock Gibson, DPT

• General Practice Dentistry in Yucaipa, CA
• Providers in Yucaipa, 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 May 31, 2009; 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.