Organization Active NPI

Natalie Mansour DMD Dental Corp

  • Pediatric Dentistry
  • Glendale, CA
National Provider Identifier
1154531432
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
49374 Issued in CA
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

Updated by the provider on Dec 10, 2014

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)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

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.

Verify at the official NPI Registry.