Individual provider Active NPI

Mariluci C Byrnes, DDS

  • Dentist
  • San Diego, CA
National Provider Identifier
1861632234
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
56929 Issued in CA
Practice address
1270 24TH St
San Diego, CA 92102-2012
Phone
(619) 234-8131
NPI assigned
Feb 25, 2009
Last updated
Apr 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 56929 CA
Dentist 122300000X 56929 CA Primary

Addresses

Primary practice location

1270 24TH St
San Diego, CA 92102-2012

Mailing address

2020 Wilbur Ave
San Diego, CA 92109-1414
Phone (619) 209-0289

Other names 1

  • Mariluci A Byrnes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
56929CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Dental Health Center of San Diego General Practice CurrentSince Jun 22, 2021 Accepting new patients
Children's Dental Health Association of San Diego Dentist CurrentSince Jun 22, 2021 Accepting new patients

Locations

1270 24th St
San Diego, CA 92102
Phone (619) 234-8131

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1861632234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 WILBUR AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921091414",
            "telephone_number": "619-209-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 24TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022012",
            "telephone_number": "619-234-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRNES",
        "first_name": "MARILUCI",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56929",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILUCI",
            "last_name": "BYRNES",
            "middle_name": "A",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.