J Maroon DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

40671 Issued in CA

Legal business name

J MAROON DDS INC

Practice address

2168 Balboa Ave Ste 1
San Diego, CA 92109-4600

Phone

(858) 273-2800

Fax

(858) 273-2888

NPI assigned

Jan 17, 2014

Organization subpart

No

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

Authorized official

Name

Dr. John Paul Maroon, DDS

Title

Owner

Phone

(858) 273-2800

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1389916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389916800000",
    "number": "1740602283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2168 BALBOA AVE STE 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094600",
            "telephone_number": "858-273-2800",
            "fax_number": "858-273-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2168 BALBOA AVE STE 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094600",
            "telephone_number": "858-273-2800",
            "fax_number": "858-273-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J MAROON DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-17",
        "last_updated": "2014-01-17",
        "status": "A",
        "authorized_official_last_name": "MAROON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-273-2800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in San Diego, CA
• Providers in San Diego, 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 17, 2014; 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.