Mahajan & Kaila Prof Dental Corp

Primary specialty

DentistTaxonomy code 122300000X

License

58280 Issued in CA

Legal business name

MAHAJAN & KAILA PROF DENTAL CORP

Practice address

12791 Newport Ave Ste 200
Tustin, CA 92780-8023

Phone

(714) 665-0005

Fax

(714) 665-0055

NPI assigned

Aug 4, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Anil Kumar Mahajan, DDS

Title

Owner

Phone

(714) 665-0005

Specialties & licenses 2

Addresses

Other names 1

• Tustin Smile Care Doing business as

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280880000000",
    "number": "1275847014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12791 NEWPORT AVE STE 200",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927808023",
            "telephone_number": "714-665-0005",
            "fax_number": "714-665-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12791 NEWPORT AVE STE 200",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927808023",
            "telephone_number": "714-665-0005",
            "fax_number": "714-665-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHAJAN & KAILA PROF DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-04",
        "last_updated": "2010-08-04",
        "status": "A",
        "authorized_official_last_name": "MAHAJAN",
        "authorized_official_first_name": "ANIL",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-665-0005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "58280",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "57847",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tustin Smile Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• August J Maggio Jr., M.D.
• Magno Physical Therapy
• Patrick Magno, DPT
• Charisse Christie Magsaysay, NP
• Noemi Magtoto
• Parvin Mahdad, DENTIST
• Duc Mai, PHARM.D.
• Jasima Y Majeed, RPH
• Marina Elia Makar
• Sanam Makhani, PHARMD

• Dentist in Tustin, CA
• Providers in Tustin, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.