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NPI Code Detail

MEDICARE: MARN DDS DENTAL PRACTICE P.C.

MEDICARE: MARN DDS DENTAL PRACTICE P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry24337CA

General Provider Information

NPI Number : 1275782641
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARN DDS DENTAL PRACTICE P.C.
Provider Business Mailing Address
First Line : PO BOX 41130
Second Line :
City : PHOENIX
State : AZ
Zip : 85080-1130
Country : US
Telephone Number : 888-833-8441
Fax Number : 888-373-9612
Provider Business Practice Location Address
First Line : 145 S FAIRFAX AVE STE 218
Second Line :
City : LOS ANGELES
State : CA
Zip : 90036-2166
Country : US
Telephone Number : 888-833-8441
Fax Number : 888-373-9612
Authorized Official
Title or Position : OWNER/DENTIST
Name : JESSICA LOO MARN
Credential : DDS
Telephone Number : 888-833-8441
Provider Enumeration Date : 09/10/2008
Last Update Date : 11/18/2025

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Directions to “MARN DDS DENTAL PRACTICE P.C. ” Practice Location

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