MARI TAKEDA (NPI# 1790916849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790916849 |
| Entity Type | Individual |
| Full Name | MARI TAKEDA |
| Credential | DMD |
| Practice Address |
2455 W Intl Speedway Blvd Daytona Beach FL 32114-1193 |
| Mailing Address |
Po Box 3189 Syracuse NY 13220-3189 |
| Practice Telephone | 8662738204 |
| Practice Fax Number | 8668034943 |
| Mailing Telephone | 8662738204 |
| Mailing Fax Number | 8668034943 |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN18436 | FL | Dental Providers |
| Street Address |
2455 W INTL SPEEDWAY BLVD |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-1193 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| 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 |
|---|---|---|---|---|
| 1548828346 | Jenna Rose Shuman | Dentist | 1540 Cornerstone Blvd Ste 100, Daytona Beach, FL 32117-7144 | 2019-06-05 |
| 1457572836 | Sutinder Singh Kohli | Dentist | 464 S Ridgewood Ave, Suite#1, Daytona Beach, FL 32114-4928 | 2007-05-01 |
| 1821110552 | Roger W Scott | Dentist | 212 Oakridge Blvd, Daytona Beach, FL 32118-4030 | 2007-04-04 |
| 1962539197 | Robbin J Quarterman | Dentist | 244 N Frederick Ave, Daytona Beach, FL 32114-3408 | 2007-02-27 |
| 1659423879 | Dave Austin Dunn | Dentist | 912 S Ridgewood Ave Ste A, Daytona Beach, FL 32114-5363 | 2007-01-17 |
| 1518016625 | Eugenio Cava | Dentist | 1500 Beville Rd Ste 403, Daytona Beach, FL 32114-5644 | 2007-01-09 |
| 1184772212 | David Richard Mccreary | Dentist | 222 Oakridge Blvd, Ste 100, Daytona Beach, FL 32118-4080 | 2007-01-08 |
| 1215016589 | Denise Turner | Dentist | 1737 North Clyde Morris Blvd, Suite 150, Daytona Beach, FL 32117 | 2006-11-06 |
| 1720179062 | Dusanka Angelov | Dentist | 1500 West Beville, Unit # 403, Daytona Beach, FL 32114 | 2006-09-28 |
| 1639288491 | Jean Chang-lowe | Dentist | 536 Health Boulevard, Daytona Beach, FL 32114 | 2006-08-29 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
Please comment or provide details below to improve the information on MARI TAKEDA.
| 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.