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DR. MARISA KAWATA WATANABE D.D.S.
NPI 1124300132
Dentist - General Practice in Tustin, CA

Active since September 15, 2011PECOS Enrolled
1405 MONTGOMERY ST, TUSTIN, CA 92782(714) 415-9409 Get Directions Write a Review

NPPES record last updated: September 15, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Marisa Kawata Watanabe D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARISA KAWATA WATANABE D.D.S. (NPI 1124300132) is an individual general practice provider in Tustin, California, licensed in California (58885) and active in the NPI registry since September 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124300132
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDR. MARISA KAWATA WATANABECredential: D.D.S.
Location Address1405 MONTGOMERY STTustin, CA 92782-1793
Mailing Address1405 Montgomery StTustin, CA 92782-1793 · (714) 415-9409
Phone(714) 415-9409
Sole ProprietorNo
Enumeration DateSeptember 15, 2011
✔ NPI 1124300132 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 58885
Definition
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.
1405 MONTGOMERY ST, Tustin, CA 92782
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Marisa Kawata Watanabe D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92782 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marisa Watanabe's NPI number?

The NPI number for Marisa Watanabe is 1124300132. It was assigned to this individual provider in the NPPES registry on September 15, 2011.

Where is Marisa Watanabe located?

Marisa Watanabe practices at 1405 Montgomery St, Tustin, CA 92782. The listed phone number is (714) 415-9409.

What is Marisa Watanabe's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Marisa Watanabe enrolled in Medicare?

Yes. Marisa Watanabe is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Marisa Watanabe was last updated on September 15, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.