NPIMap

Organization Active NPI

Pakravan, Manavi & Cohen Dental Corporation

  • Dentist
  • Rancho Cucamonga, CA
National Provider Identifier
1306348768
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
39862 Issued in CA
Legal business name
PAKRAVAN, MANAVI & COHEN DENTAL CORPORATION
Practice address
7210 Day Creek Blvd
Suite 110
Rancho Cucamonga, CA 91739
Phone
(310) 820-9933
Fax
(310) 820-0408
NPI assigned
Mar 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Authorized official

Name
Miguel Reyes
Title
Q/a Contract & Compliance Manager
Phone
(310) 820-9933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 39862 CA Primary

Addresses

Primary practice location

7210 Day Creek Blvd
Suite 110
Rancho Cucamonga, CA 91739

Mailing address

12121 Wilshire Blvd Ste 1111
Los Angeles, CA 90025-1188
Phone (310) 820-9933

Other names 1

  • WEST COAST DENTAL GROUP OF RANCHO CUCAMONGA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pakravan Manavi Cohen Dental Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7210 Day Creek Blvd
Ste 110
Rancho Cucamonga, CA 91739
Phone (909) 667-2550

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": "1519862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1306348768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 WILSHIRE BLVD STE 1111",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251188",
            "telephone_number": "310-820-9933",
            "fax_number": "310-820-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 DAY CREEK BLVD",
            "address_2": "SUITE 110",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91739",
            "telephone_number": "310-820-9933",
            "fax_number": "310-820-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAKRAVAN, MANAVI & COHEN DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-01",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_title_or_position": "Q/A CONTRACT & COMPLIANCE MANAGER",
        "authorized_official_telephone_number": "310-820-9933"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "39862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WEST COAST DENTAL GROUP OF RANCHO CUCAMONGA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.