DR. MARK JONATHAN MATERUM (NPI# 1033750567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033750567 |
| Entity Type | Individual |
| Full Name | DR. MARK JONATHAN MATERUM |
| Credential | DDS |
| Practice Address |
343 Gellert Blvd Ste A Daly City CA 94015-2620 |
| Practice Telephone | 6509910611 |
| Mailing Telephone | 6509910611 |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2019-10-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
103450 | CA | Dental Providers |
| Street Address |
343 GELLERT BLVD STE A |
| City | DALY CITY |
| State | CA |
| Zip Code | 94015-2620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881235901 | Fast Express Ride Inc | Non-emergency Medical Transport (VAN) | 381 Westlake Ctr # 292, Daly City, CA 94015 | 2019-09-30 |
| 1598231888 | National Vision Inc | Technician/Technologist | 148a Serramonte Center, Daly City, CA 94015 | 2018-10-15 |
| 1174017313 | Glaiza Cecilia S Canares | Student in an Organized Health Care Education/Training Program | 255 Dennis Drive, Daly City, CA 94015 | 2018-06-20 |
| 1154869477 | Noah Bautista | Massage Therapist | 151 87th St Suite 4, Daly City, CA 94015 | 2017-02-07 |
| 1417387291 | Accuquest Hearing Centers | Clinic/Center | 10 Park Plaza Dr., Daly City, CA 94015 | 2013-11-15 |
| 1801193800 | Carol Crane | Physical Therapy Assistant | 333 Gellert Dr., Suite 150, Supplemental Health Care, Daly City, CA 94015 | 2011-02-28 |
| 1366753808 | Emerito Cesar C Nunag | Physical Therapy Assistant | 595 Clarinada Avenue #2, Daly City, CA 94015 | 2010-06-30 |
| 1356668016 | Lauren Rose Hendrick | Marriage & Family Therapist | 355 Gellert Blvd Suite 280, Daly City, CA 94015 | 2010-04-21 |
| 1205061868 | Isabel A. Walsh | General Practice | 783 Skyline Dr., Daly City, CA 94015 | 2009-05-26 |
| 1790933539 | Frank Geoffrey Yeh | Dentist | 1440 Southgate Ave., Daly City, CA 94015 | 2008-09-05 |
| Find all providers in zip 94015 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831547678 | Richard Sladkov Brewer | Dentist | 276 Westbrook Ave, Daly City, CA 94015-3419 | 2016-06-02 |
| 1487974150 | Raymond Jone | Dentist | 6433 Mission St, Daly City, CA 94014-2072 | 2010-06-04 |
| 1114250735 | Vivian Sami Khoury | Dentist | 341 Westlake Ctr Ste 330, Daly City, CA 94015-1443 | 2009-09-14 |
| 1821246521 | Bo Jun | Dentist | 343 Gellert Blvd Ste C, Daly City, CA 94015-2620 | 2008-09-05 |
| 1033365119 | Wei-yi Y Chao | Dentist | 252 Eastmoor Ave, Daly City, CA 94015-2035 | 2008-08-08 |
| 1962665091 | Yoshi Fun-zu Shen | Dentist | 550 Washington St Ste 106, Daly City, CA 94015-1929 | 2008-07-09 |
| 1861686362 | Epitacio Mendoza Sison Jr. | Dentist | 2085 Gellert Blvd Ste 9, Daly City, CA 94015-2841 | 2007-08-29 |
| 1740489624 | Kelvin Tan | Dentist | 220 First Ave, Daly City, CA 94014 | 2007-07-12 |
| 1205030822 | Maria Diana G. Tolosa | Dentist | 7119 Mission St, Daly City, CA 94014-2202 | 2007-06-14 |
| 1376754614 | Rowena B Baltazar | Dentist | 180 Skyline Plz, Daly City, CA 94015-3823 | 2007-05-25 |
| Find all providers in DALY CITY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.