Individual provider Active NPI

Martha Patricia Parroquin, D.D.S.

  • General Practice Dentistry
  • North Hollywood, CA
National Provider Identifier
1790963577
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
56576 Issued in CA
Practice address
12632 Welby Way
North Hollywood, CA 91606-1212
Phone
(626) 960-9966
Fax
(626) 962-9136
NPI assigned
Feb 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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 56576 CA Primary

Addresses

Primary practice location

12632 Welby Way
North Hollywood, CA 91606-1212

Mailing address

12632 Welby Way
North Hollywood, CA 91606-1212
Phone (626) 960-9966

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
I20160309002645 CA Order and Referring Only - DentistPractitioner - Dentist 9436455953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56576CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Parroquin Family Dental Practice, Inc. Current Accepting new patients

Locations

11335 Magnolia Blvd
Ste 1B
North Hollywood, CA 91601
Phone (818) 763-4040

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": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1790963577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12632 WELBY WAY",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916061212",
            "telephone_number": "626-960-9966",
            "fax_number": "626-962-9136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12632 WELBY WAY",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916061212",
            "telephone_number": "626-960-9966",
            "fax_number": "626-962-9136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARROQUIN",
        "first_name": "MARTHA",
        "middle_name": "PATRICIA",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

Verify at the official NPI Registry.