Mallery Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38166 Issued in CA

Legal business name

MALLERY DENTAL CORPORATION

Doing business as

Capistrano Dental Group

Practice address

31878 Del Obispo St
Ste. 105
San Juan Capistrano, CA 92675-3223

Phone

(949) 487-3273

Fax

(949) 487-0322

NPI assigned

Sep 25, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Brian D Buehler, DDS

Title

Owner DDS

Phone

(949) 487-3273

Specialties & licenses 1

Addresses

Other names 1

• CAPISTRANO DENTAL GROUP Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063512192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE",
            "address_2": "2ND FLOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061009",
            "telephone_number": "714-508-3600",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31878 DEL OBISPO ST",
            "address_2": "STE. 105",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926753223",
            "telephone_number": "949-487-3273",
            "fax_number": "949-487-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLERY DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUEHLER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER DDS",
        "authorized_official_telephone_number": "949-487-3273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAPISTRANO DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dania Magill, B.S.
• Mary Claire Malooly, PT, DPT, ATC
• Jose Luis Mancilla Jr.
• Pat Anne Mann, M.A.
• Jennifer Rebecca Mansoor
• Derek Mantey, MS, ATC, PTA

• General Practice Dentistry in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.