Organization Active NPI

Marlize Atallah Ayoub DDS Inc.

  • Dental Clinic/Center
  • Huntington Beach, CA
National Provider Identifier
1881005023
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
57890 Issued in CA
Legal business name
MARLIZE ATALLAH AYOUB DDS INC.
Practice address
8201 Newman Ave Ste 302
Huntington Beach, CA 92647-7058
Phone
(714) 848-0910
NPI assigned
May 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Authorized official

Name
Dr. Marlize AyoubNPI 1063637700
Title
Dentist/ Office Manager
Phone
(714) 848-0910

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 57890 CA Primary

Addresses

Primary practice location

8201 Newman Ave Ste 302
Huntington Beach, CA 92647-7058

Mailing address

8201 Newman Ave Ste 302
Huntington Beach, CA 92647-7058
Phone (714) 848-0910

Other practice location 1

8201 Newman Ave Ste 101
Huntington Beach, CA 92647-7043
Phone (714) 435-0075

Other identifiers 1

IdentifierTypeStateIssuer
14073600034OtherCAPENDING MEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230206000097 CA Part B Supplier - Clinic/Group Practice 9830577014 Receives reassigned benefits from 1 practitioner
Practice locations: Huntington Beach, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1399593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597708800000",
    "number": "1881005023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 NEWMAN AVE STE 302",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477058",
            "telephone_number": "714-848-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 NEWMAN AVE STE 302",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477058",
            "telephone_number": "714-848-0910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8201 Newman Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Huntington Beach",
            "state": "CA",
            "postal_code": "926477043",
            "country_code": "US",
            "telephone_number": "714-435-0075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARLIZE ATALLAH AYOUB DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-09",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A",
        "authorized_official_last_name": "AYOUB",
        "authorized_official_first_name": "MARLIZE",
        "authorized_official_title_or_position": "DENTIST/ OFFICE MANAGER",
        "authorized_official_telephone_number": "714-848-0910",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "57890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENDING MEDICAID",
            "identifier": "14073600034",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.