Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
MARIO A GODINEZ
Active
Individual
MARIO A GODINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
48807
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203185082
FEDERAL TAX ID
CA
01
—
48807
STATE LICENSE NUMBER
CA
Enumeration date
05/08/2007
Last updated
04/08/2022
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