Maite Vargas Dental Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

54219 Issued in CA

Legal business name

MAITE VARGAS DENTAL CORPORATION

Doing business as

Dentist on Wheels Ca

Practice address

500 S Broadway
Suite 246
Santa Maria, CA 93454-5148

Phone

(855) 369-8585

NPI assigned

Sep 12, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Maite Vargas, DDS

Title

Ceo

Phone

(786) 554-9845

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DENTIST ON WHEELS CA Doing business as

Locations

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1750716452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S BROADWAY",
            "address_2": "SUITE 246",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545148",
            "telephone_number": "855-369-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S BROADWAY",
            "address_2": "SUITE 246",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545148",
            "telephone_number": "855-369-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAITE VARGAS DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-12",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "VARGAS",
        "authorized_official_first_name": "MAITE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-554-9845",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "54219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL BOARD OF CALIFORNIA",
            "identifier": "54219",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DENTIST ON WHEELS CA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Blair Mahoney, M.D.
• Jaclyn Mahoney
• Laurie Ann Mahr, LMFT
• Main Dental Center
• Gabrielle Maiolo
• Brandon Malan, DDS
• Juliana Malaveci, LCSW
• Eliadora Maldanado, BA
• Magaly Maldonado Vivar
• Yesenia Maldonado-Cansimbe

• Dental Clinic/Center in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.