Active NPI
Marina Atef Danial Kalds, DDS
- General Practice Dentistry
- Santa Ana, CA
National Provider Identifier
1710754759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 109667
- Practice address
- 1125 W 17TH St
Santa Ana, CA 92706-3505 - Phone
- (949) 254-1234
- NPI assigned
- Dec 11, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 109667 | CA | Primary |
Addresses
Primary practice location
1125 W 17TH St
Santa Ana, CA 92706-3505
Mailing address
15888 Bogart CT
Fountain Valley, CA 92708-1206
Phone (714) 650-6283
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 |
|---|---|---|---|
| 109667 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702252800000",
"number": "1710754759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15888 BOGART CT",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927081206",
"telephone_number": "714-650-6283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 W 17TH ST",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927063505",
"telephone_number": "949-254-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALDS",
"first_name": "MARINA",
"middle_name": "ATEF DANIAL",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-11",
"last_updated": "2023-12-11",
"certification_date": "2023-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "109667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.