Individual provider Active NPI

Mark Edward Estey, D.D.S.

  • Dentist
  • Redlands, CA
National Provider Identifier
1942501051
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
45253 Issued in CA
Practice address
1806 Orange Tree LN
Suite B
Redlands, CA 92374-4569
Phone
(909) 335-1166
Fax
(909) 335-1375
NPI assigned
Nov 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 45253 CA Primary

Addresses

Primary practice location

1806 Orange Tree LN
Suite B
Redlands, CA 92374-4569

Mailing address

1806 Orange Tree LN
Suite B
Redlands, CA 92374-4569
Phone (909) 335-1166

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
I20170801000402 CA Order and Referring Only - DentistPractitioner - Dentist 5496026023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
45253CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Estey and Carpenter Dental Corporation Dentist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1942501051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 ORANGE TREE LN",
            "address_2": "SUITE B",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744569",
            "telephone_number": "909-335-1166",
            "fax_number": "909-335-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 ORANGE TREE LN",
            "address_2": "SUITE B",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744569",
            "telephone_number": "909-335-1166",
            "fax_number": "909-335-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTEY",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-04",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "45253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.