Dr. Naminik Dental Group Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DR. NAMINIK DENTAL GROUP INC.

Practice address

22817 Lyons Ave
Santa Clarita, CA 91321-2819

Phone

(661) 200-3130

Fax

(661) 476-5675

NPI assigned

Jun 10, 2024

Organization subpart

No

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

Authorized official

Name

Guadalupe Gonzalez

Title

Office Administrator

Phone

(661) 200-3130

Specialties & licenses 2

Addresses

Other names 1

• Lyons Dental Specialties Doing business as

Locations

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1124860291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22817 LYONS AVE",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913212819",
            "telephone_number": "661-200-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22817 LYONS AVE",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913212819",
            "telephone_number": "661-200-3130",
            "fax_number": "661-476-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. NAMINIK DENTAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "GUADALUPE",
        "authorized_official_title_or_position": "OFFICE  ADMINISTRATOR",
        "authorized_official_telephone_number": "661-200-3130"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lyons Dental Specialties",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.