Maritone Suansing Olaer, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

55264 Issued in CA

Practice address

1855 N Fair Oaks Ave # G100
Pasadena, CA 91103-1620

Phone

(626) 398-5970

Fax

(626) 398-6144

NPI assigned

May 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922214501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 E CALORA ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917222157",
            "telephone_number": "626-339-8434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 N FAIR OAKS AVE # G100",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031620",
            "telephone_number": "626-398-5970",
            "fax_number": "626-398-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAER",
        "first_name": "MARITONE",
        "middle_name": "SUANSING",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "55264",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robbin Kikuo Okamoto, DDS
• Odinaka Jason Okegbe
• Michael Oghenetega Okene
• Chibuike Ikechukwu Okigbo
• Deana Harumi Okohira, PHARM. D.
• Emiliano Olague
• Ronald P Olah, MD
• N Olatunji Olambiwonnu, M.D.
• Daisy Olaya
• Chantal Johanna Olenczuk, OTR/L

• General Practice Dentistry in Pasadena, CA
• Providers in Pasadena, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.