MEDICARE: MELINDA KAPLOW-MARINO DDS

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
1	122300000X	Dentist	45145	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1366802878	OTHER	CA	NPI

General Provider Information

NPI Number	:	1598773541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINDA KAPLOW-MARINO DDS

Provider Business Mailing Address
First Line	:	8901 ACTIVITY RD STE 203
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-4427
Country	:	US
Telephone Number	:	858-578-0800
Fax Number	:	858-578-0444

Provider Business Practice Location Address
First Line	:	8901 ACTIVITY RD STE 203
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-4436
Country	:	US
Telephone Number	:	858-578-0800
Fax Number	:	858-578-0444

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	01/05/2022

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