Ma Rosario Gutierrez Exconde, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

50414 Issued in CA

Practice address

133 Plaza Dr
Suite R
Vallejo, CA 94591-3703

Phone

(707) 557-6245

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Exconde-Evangelista Dental Corporation

  • Dental Clinic/Center
  • Hayward, CA
  • NPI 1568928778
  NPD Authorized official
• Maria T Alarcon DDS Dental Corporation

  • Dental Clinic/Center
  • Hayward, CA
  • NPI 1467955369
  Medicare reassignment
• Marosario G. Exconde,DDS,Inc.

  • General Practice Dentistry
  • Pittsburg, CA
  • NPI 1477765923
  NPD (past) Authorized official

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1922196559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 ARGUELLO DR",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945103987",
            "telephone_number": "707-747-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 PLAZA DR",
            "address_2": "SUITE R",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945913703",
            "telephone_number": "707-557-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EXCONDE",
        "first_name": "MA ROSARIO",
        "middle_name": "GUTIERREZ",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50414",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "50414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evergreen at Springs Road, L.L.C.
• Tosan Adaze Elise Eweka
• Marsha Lee Ewig, MSW
• Excel Therapy Group, Inc.
• Exclusive Enterprises Inc
• Inna Eydelnant, OTR/L
• Rose Anne Fabillar
• Matthew J Fagan, D.O.
• Ann M Fahey
• Gail R Fahey, RN

• Oral and Maxillofacial Surgery (Dentist) in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.