NPIMap

Organization Active NPI

Marilou D. Elido, DMD, Inc.

  • General Practice Dentistry
  • Tustin, CA
National Provider Identifier
1902098809
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43942 Issued in CA
Legal business name
MARILOU D. ELIDO, DMD, INC.
Practice address
13812 Newport Ave
Suite 101
Tustin, CA 92780-7810
Phone
(714) 838-8881
Fax
(714) 838-1808
NPI assigned
Aug 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2007

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

Authorized official

Name
Dr. Marilou Dyquiangco Elido, DDSNPI 1770641771
Title
Dr
Phone
(714) 838-8881

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 43942 CA Primary

Addresses

Primary practice location

13812 Newport Ave
Suite 101
Tustin, CA 92780-7810

Mailing address

13812 Newport Ave
Suite 101
Tustin, CA 92780-7810
Phone (714) 838-8881

Other identifiers 1

IdentifierTypeStateIssuer
B43942-02OtherCACALIFORNIA MEDICAL DENTAL

National Provider Directory

National Provider Directory

Locations

13812 Newport Ave
Ste 101
Tustin, CA 92780
Phone (714) 838-8881

Practitioners & affiliated clinicians

Practitioners 3

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": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187049600000",
    "number": "1902098809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13812 NEWPORT AVE",
            "address_2": "SUITE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807810",
            "telephone_number": "714-838-8881",
            "fax_number": "714-838-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13812 NEWPORT AVE",
            "address_2": "SUITE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807810",
            "telephone_number": "714-838-8881",
            "fax_number": "714-838-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILOU D. ELIDO, DMD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2007-08-14",
        "status": "A",
        "authorized_official_last_name": "ELIDO",
        "authorized_official_first_name": "MARILOU",
        "authorized_official_middle_name": "DYQUIANGCO",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "714-838-8881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA MEDICAL DENTAL",
            "identifier": "B43942-02",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; 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.