Mark O Manoukian Dental Corp

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

MARK O MANOUKIAN DENTAL CORP

Practice address

655 Redwood Hwy Frontage Rd Ste 120
Mill Valley, CA 94941-3068

Phone

(415) 383-1200

Fax

(415) 383-1500

NPI assigned

Sep 7, 2026

Organization subpart

No

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

Authorized official

Name

Michaela Muniz

Title

VP, Payor Relations

Phone

(469) 324-3242

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1788739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788739200000",
    "number": "1093624827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 REDWOOD HWY FRONTAGE RD STE 120",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949413068",
            "telephone_number": "415-383-1200",
            "fax_number": "415-383-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 REDWOOD HWY FRONTAGE RD STE 120",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949413068",
            "telephone_number": "415-383-1200",
            "fax_number": "415-383-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK O MANOUKIAN DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-07",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-06",
        "status": "A",
        "authorized_official_last_name": "MUNIZ",
        "authorized_official_first_name": "MICHAELA",
        "authorized_official_title_or_position": "VP, PAYOR RELATIONS",
        "authorized_official_telephone_number": "469-324-3242"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alexis A Martinez, PA-C
• John Michael Martinez, M.D.
• Krystle Rose Martinez
• Harris Avery Masket, M.D.

• Endodontics in Mill Valley, CA
• Providers in Mill Valley, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.