Mari Takeda, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN18436 Issued in FL

Practice address

2455 W Intl Speedway Blvd
Daytona Beach, FL 32114-1193

Phone

(866) 273-8204

Fax

(866) 803-4943

NPI assigned

Aug 6, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1790916849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "866-273-8204",
            "fax_number": "866-803-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 W INTL SPEEDWAY BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141193",
            "telephone_number": "866-273-8204",
            "fax_number": "866-803-4943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKEDA",
        "first_name": "MARI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-06",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Lynne Szymczak, RPH
• Ayesha Tabassom
• Samy S Tadros, PT
• Dorey L. Taggart, A.R.N.P.
• Tailor-Made Medical Solutions
• Erin Taliaferro, PT, DPT
• Cemiyah Talton
• Amanda Tam
• Tamara Johnson
• Sarah Tamayo

• General Practice Dentistry in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.