Maribel Vicente, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

42707 Issued in CA

Practice address

5555 Jackson Dr
210
La Mesa, CA 91942-2452

Phone

(619) 462-3552

Fax

(619) 271-1514

NPI assigned

Oct 16, 2007

Sex

Female

Sole proprietor

Yes

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

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

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1801085758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 JACKSON DR",
            "address_2": "210",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422452",
            "telephone_number": "619-462-3552",
            "fax_number": "619-271-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 JACKSON DR",
            "address_2": "210",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422452",
            "telephone_number": "619-462-3552",
            "fax_number": "619-271-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICENTE",
        "first_name": "MARIBEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "42707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sadira Ventura
• Juan Carlos Vera, M.D.
• Judith Ann Verbanets, P.T.
• Anna Vladimirovna Verner, FNP
• Christine Vetere
• Victor E Seikaly MD a Professional Corporation
• Victoria Sharma MD Inc
• J Michael Vidal, O.D.
• Ryan B Viets, MD
• Jose Elias Villafana, MFT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.