Individual provider Active NPI

Mary Jane Salazar-Linayao, DDS

  • General Practice Dentistry
  • Pinole, CA
National Provider Identifier
1770659773
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33545 Issued in CA
Practice address
2762 Pinole Valley Rd
Pinole, CA 94564-1425
Phone
(510) 758-6684
Fax
(510) 669-2083
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 33545 CA Primary

Addresses

Primary practice location

2762 Pinole Valley Rd
Pinole, CA 94564-1425

Mailing address

2762 Pinole Valley Rd
Pinole, CA 94564-1425
Phone (510) 758-6684

Other practice location 1

8201 Edgewater Dr Ste 106
Oakland, CA 94621-2021
Phone (510) 568-3577

Other names 1

  • Mary Jane Salazar Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160106001084 CA Order and Referring Only - DentistPractitioner - Dentist 6800198979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33545CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey P Alexander DDS a Dental Corp General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1770659773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2762 PINOLE VALLEY RD",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945641425",
            "telephone_number": "510-758-6684",
            "fax_number": "510-669-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2762 PINOLE VALLEY RD",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945641425",
            "telephone_number": "510-758-6684",
            "fax_number": "510-669-2083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8201 Edgewater Dr Ste 106",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946212021",
            "country_code": "US",
            "telephone_number": "510-568-3577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALAZAR-LINAYAO",
        "first_name": "MARY JANE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "33545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY JANE",
            "last_name": "SALAZAR",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pinole, CA

Sources for this page

Verify at the official NPI Registry.