Active NPI
Natalie Mansour DMD Dental Corp
- Pediatric Dentistry
- Glendale, CA
National Provider Identifier
1154531432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 49374
- Legal business name
- NATALIE MANSOUR DMD DENTAL CORP
- Practice address
- 709 S Central Ave
Suite a
Glendale, CA 91204-2010 - Phone
- (818) 500-7330
- Fax
- (818) 500-7340
- NPI assigned
- May 23, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Natalie Chantal Mansour, DMD
- Title
- President
- Phone
- (310) 902-7775
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 49374 | CA | Primary |
Addresses
Primary practice location
709 S Central Ave
Suite a
Glendale, CA 91204-2010
Mailing address
615 Clinton PL
Beverly Hills, CA 90210-1917
Phone (310) 902-7775
National Provider Directory
National Provider DirectoryLocations
709 S Central Ave
Ste A
Glendale, CA 91204
Phone (818) 500-7330
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Glendale, CA
- NPI 1134227796
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1418169600000",
"number": "1154531432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 CLINTON PL",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902101917",
"telephone_number": "310-902-7775",
"fax_number": "310-858-8333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 S CENTRAL AVE",
"address_2": "SUITE A",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912042010",
"telephone_number": "818-500-7330",
"fax_number": "818-500-7340"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NATALIE MANSOUR DMD DENTAL CORP",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-23",
"last_updated": "2014-12-10",
"status": "A",
"authorized_official_last_name": "MANSOUR",
"authorized_official_first_name": "NATALIE",
"authorized_official_middle_name": "CHANTAL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "310-902-7775",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "49374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.