Mylad Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MYLAD DENTAL CORPORATION

Practice address

24119 Hemlock Ave Ste 108
Moreno Valley, CA 92557-7221

Phone

(951) 220-6980

Fax

(951) 465-2634

NPI assigned

Aug 30, 2023

Organization subpart

No

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

Authorized official

Name

Botamena Mylad, DDS

Title

Owner

Phone

(951) 220-6980

Specialties & licenses 1

Addresses

Other names 1

• Moreno Valley Modern Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Noah Poole, DDS

  • Dentist
  • Moreno Valley, CA
  • NPI 1548151574
  NPD

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1215712906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24119 HEMLOCK AVE STE 108",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577221",
            "telephone_number": "951-220-6980",
            "fax_number": "951-465-2634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYLAD DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "MYLAD",
        "authorized_official_first_name": "BOTAMENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-220-6980",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moreno Valley Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ellinah Kalumu Mutuku, LVN
• MVP RX LLC
• Beatrice Nduku Mwania, LVN
• Florence Kanyua Mwiti
• Cedrina Ramona Myers, REGISTERED DIETITIAN
• Mymy Transit, LLC
• Myung Kee Park DDS Inc
• Sherri Grace Myung, FNP
• Danny NA, PMHNP-BC
• Emma Elizabeth Naatz, MD

• General Practice Dentistry in Moreno Valley, CA
• Providers in Moreno Valley, 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 30, 2023; 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.