MISS MARISTELA TAN D.M.D.
NPI 1164569646
Dentist in Fairfield, CA

Q: What is Maristela Tan's NPI number?

The NPI number for Maristela Tan is 1164569646. It was assigned to this individual provider in the NPPES registry on January 31, 2007.

Q: What is Maristela Tan's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Maristela Tan was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since January 31, 2007PECOS Enrolled

2440 N TEXAS ST, FAIRFIELD, CA 94533(707) 422-4600(707) 422-0396 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Miss Maristela Tan D.m.d. NPPES

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

MISS MARISTELA TAN D.M.D. (NPI 1164569646) is an individual dentist in Fairfield, California, licensed in California (50829) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164569646

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameMISS MARISTELA TANCredential: D.M.D.

Location Address2440 N TEXAS STFairfield, CA 94533-1602

Mailing Address2440 N Texas StFairfield, CA 94533-1602 · (707) 422-4600 · Fax (707) 422-0396

Phone(707) 422-4600

Fax(707) 422-0396

Sole ProprietorNo

Enumeration DateJanuary 31, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1164569646 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in CA · 50829

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

2440 N TEXAS ST, Fairfield, CA 94533

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miss Maristela Tan D.m.d. 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 94533 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

$98.85 typical visit price

range $65.02 – $191.95

Typical copayment $24.71 (range $16.25 – $47.98)

Most-billed visit code 99203

Established Patient

$80.24 typical visit price

range $21.86 – $157.69

Typical copayment $20.06 (range $5.46 – $39.42)

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.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GUNJAN HITENDRAKUMAR JOSHI DDS

Dentist (General Practice)