Roberto Amisael Marroquin, DDS
Dentist in Ventura, CA. Individual provider (NPI-1).
NPI number1205423720
StatusActive
Last updated in NPPESDec 30, 2020
Details
- NPI
- 1205423720
- Entity type
- Individual (NPI-1)
- Name
- Roberto Amisael Marroquin
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 30, 2020
- Certification date
- Dec 26, 2020
- Last updated
- Dec 30, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 105890 | CA | Yes |
Practice location
1708 S Victoria Ave Ste BVentura, CA 93003-6595
Phone 805-941-1001
Mailing address
816 W 56th StLos Angeles, CA 90037-3624
Phone 323-537-7281
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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