Maribelle Tam DDS Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45030 Issued in CA

Legal business name

MARIBELLE TAM DDS INC.

Practice address

1217 Huntington Dr
Duarte, CA 91010-2454

Phone

(626) 357-7778

Fax

(626) 357-8701

NPI assigned

Mar 15, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Maribelle Tam, DDSNPI 1518024017

Title

President

Phone

(626) 357-7778

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maribelle Tam, DDS

  • General Practice Dentistry
  • Duarte, CA
  • NPI 1518024017
  NPD (past) Authorized official

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861526410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 HUNTINGTON DR",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102454",
            "telephone_number": "626-357-7778",
            "fax_number": "626-357-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 HUNTINGTON DR",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102454",
            "telephone_number": "626-357-7778",
            "fax_number": "626-357-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIBELLE TAM DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TAM",
        "authorized_official_first_name": "MARIBELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-357-7778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "G93061-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mani Manouchehrian, PHARM.D
• Saro Berj Manoukian, MD
• Peter N Mansour
• Guido Marcucci, M.D.
• Mari-Mina Pharmaceuticals Inc (Del's Pharmacy II)
• Claudia Marin
• Martha Hayworth Marion, AMFT
• Jeremy Mark, PA-C
• Tanya Markary
• Sean Maroongroge, M.D.

• General Practice Dentistry in Duarte, CA
• Providers in Duarte, 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 Aug 22, 2020; 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.