Mary H. Patuwo, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

B36411-01 Issued in CA

Practice address

14796 Beach Blvd
La Mirada, CA 90638-4217

Phone

(714) 562-0402

Fax

(714) 562-0248

NPI assigned

Oct 3, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mary H. Patuwo DDS, Inc.

  dba Soft-Touch Family Dental

  • Dentist
  • La Mirada, CA
  • NPI 1659423226
  NPD (past)

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191369600000",
    "number": "1760679716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14796 BEACH BLVD",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906384217",
            "telephone_number": "714-562-0402",
            "fax_number": "714-562-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14796 BEACH BLVD",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906384217",
            "telephone_number": "714-562-0402",
            "fax_number": "714-562-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATUWO",
        "first_name": "MARY",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "B36411-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORP NPI",
            "identifier": "1659423226",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sehjin Park
• Sung Wook Park, DDS
• Khulwinder Singh Parmar, D.C.
• Torrey Parry, M.D.
• Neelam Patel
• Carla M Payton-Shelton
• Peaceful Nest Birth and Sleep LLC
• Laura K Pedigo, PSYD
• Christopher Rhee Pelton Sr., PTA
• Emily Nicole Othello Perez, M.D.

• Dentist in La Mirada, CA
• Providers in La Mirada, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.