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DR. MARC DENTICO-OLIN DMD, MD
NPI 1629205174
Dentist - Oral and Maxillofacial Surgery in San Diego, CA

Active since June 11, 2009PECOS EnrolledAccepts Medicare Assignment
501 WASHINGTON ST STE 710, SAN DIEGO, CA 92103(619) 295-6774(619) 295-6776 Get Directions Write a Review

NPPES record last updated: June 19, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 19, 2020, Nov 15, 2016, Feb 2, 2016 (3 updates tracked since 2016).

About Dr. Marc Dentico-olin Dmd, Md NPPES

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

DR. MARC DENTICO-OLIN DMD, MD (NPI 1629205174) is an individual oral and maxillofacial surgery provider in San Diego, California, licensed in California (A143794) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, maintains a secondary practice location in San Diego, and is a graduate of Icahn School Of Medicine At Mount Sinai (2012).

NPPES Registry Identity

NPI1629205174
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. MARC DENTICO-OLINCredential: DMD, MD
Location Address501 WASHINGTON ST STE 710San Diego, CA 92103-2231
Mailing Address501 Washington St Ste 710San Diego, CA 92103-2231 · (619) 295-6774 · Fax (619) 295-6776
Phone(619) 295-6774
Fax(619) 295-6776
Sole ProprietorNo
Medical School CMSIcahn School Of Medicine At Mount SinaiGraduated 2012
Enumeration DateJune 11, 2009
Last NPPES UpdateJune 19, 20203 updates tracked since enumeration
NPPES CertifiedJune 19, 2020
✔ NPI 1629205174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Licenses✔ Licensed in CA · A143794✔ Licensed in CA · OMS109
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Also ListedSpecialistTaxonomy 174400000X · License A143794 (CA)
501 WASHINGTON ST STE 710, San Diego, CA 92103
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Secondary Practice Location 1

Location 18008 Frost St, Suite 311San Diego, CA 92123-4205 · Phone (858) 292-6033 · Fax (858) 292-0305

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas 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 and accepts Medicare assignment

Dr. Marc Dentico-olin Dmd, Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739462995
PECOS Enrollment IDI20170213002658
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 92103 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
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

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

LESTER MACHADO, M.D., D.D.S., INC
Dentist (Oral and Maxillofacial Surgery)
501 WASHINGTON ST STE 710
SAN DIEGO, CA 92103
San Diego County (619) 295-6774

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 Marc Dentico-olin's NPI number?

The NPI number for Marc Dentico-olin is 1629205174. It was assigned to this individual provider in the NPPES registry on June 11, 2009.

Where is Marc Dentico-olin located?

Marc Dentico-olin practices at 501 Washington St Ste 710, San Diego, CA 92103. The listed phone number is (619) 295-6774.

What is Marc Dentico-olin's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Marc Dentico-olin enrolled in Medicare?

Yes. Marc Dentico-olin is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Marc Dentico-olin accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Florida Combined Life and Humana and 1 other insurer list Marc Dentico-olin as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Marc Dentico-olin was last updated on June 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.