Individual provider Active NPI

Marianne Wolford, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Oakland, CA
National Provider Identifier
1871650473
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
34592 Issued in CA
Practice address
1530 Broadway
Oakland, CA 94612-2002
Phone
(510) 251-8006
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 34592 CA Primary

Addresses

Primary practice location

1530 Broadway
Oakland, CA 94612-2002

Mailing address

105 Westchester St
Moraga, CA 94556-1756
Phone (925) 377-1297

Other identifiers 1

IdentifierTypeStateIssuer
D34592OtherCADENTICAL PROVIDER #

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
I20151020000419 CA Order and Referring Only - DentistPractitioner - Dentist 1355650011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34592CAMDChiropractor

Interoperability endpoints

  • Direct secure messaging: mwolford@direct.westerndental.com

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871650473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WESTCHESTER ST",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945561756",
            "telephone_number": "925-377-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 BROADWAY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946122002",
            "telephone_number": "510-251-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFORD",
        "first_name": "MARIANNE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "34592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL PROVIDER #",
            "identifier": "D34592",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.