Marcello Indelicato, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

59435 Issued in CA

Practice address

1020 Magnolia Ave
Larkspur, CA 94939-1016

Phone

(415) 937-1125

NPI assigned

Jul 6, 2010

Sex

Male

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

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.

• Matthew S Yarborough DDS Inc

  • Dental Clinic/Center
  • Larkspur, CA
  • NPI 1811457500
  NPD (past)

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1801108907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 MAGNOLIA AVE",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391016",
            "telephone_number": "415-937-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 MAGNOLIA AVE",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391016",
            "telephone_number": "415-937-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDELICATO",
        "first_name": "MARCELLO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy Lynn Husen, DDS
• Hyatt Subido Dental Group, Inc, a Professional Corporation
• Eliza Hyatt, D.D.S.
• Elizaveta Ignatova, MD
• Incare Home Care, LLC
• Infraway LLC
• Vivek Iyer, MD
• Alyssa Powell Jaffe, NP
• Regina Jarin
• Chris Kane

• General Practice Dentistry in Larkspur, CA
• Providers in Larkspur, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.