Individual provider Active NPI

Macye Pau, DMD

  • Dentist
  • Fresno, CA
National Provider Identifier
1982174413
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS110003 Issued in CA
Practice address
1008 W Shaw Ave Ste 105
Fresno, CA 93711-3723
Phone
(559) 227-0027
NPI assigned
Nov 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS110003 CA Primary

Addresses

Primary practice location

1008 W Shaw Ave Ste 105
Fresno, CA 93711-3723

Mailing address

1008 W Shaw Ave Ste 105
Fresno, CA 93711-3723

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
I20240826000442 CA Order and Referring Only - DentistPractitioner - Dentist 8224577044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110003CAMDClinical Social Worker
DDS110003CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ghazal Gill and Lambridis Dental Corporation Dentist PastSince May 26, 2024 Accepting new patients
California Autism Center, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1982174413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 W SHAW AVE STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 W SHAW AVE STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113723",
            "telephone_number": "559-227-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAU",
        "first_name": "MACYE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS110003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.