NPIMap

Organization Active NPI

Michael Vincent Laureola DDS Inc

  • Pediatric Dentistry
  • Torrance, CA
National Provider Identifier
1316117104
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
55121 Issued in CA
Legal business name
MICHAEL VINCENT LAUREOLA DDS INC
Doing business as
MAGICLAND DENTAL GROUP
Practice address
3820 Sepulveda Blvd
Torrance, CA 90505-2408
Phone
(310) 792-5200
Fax
(310) 792-5201
NPI assigned
Mar 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Authorized official

Name
Dr. Michael Vincent Laureola
Title
President
Phone
(310) 792-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 55121 CA Primary

Addresses

Primary practice location

3820 Sepulveda Blvd
Torrance, CA 90505-2408

Mailing address

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

Other names 1

  • MAGICLAND DENTAL GROUP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Magicland Dental Group5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

21229 Hawthorne Blvd
Ste B
Torrance, CA 90503
Phone (310) 792-5200

3820 Sepulveda Blvd
Torrance, CA 90505
Phone (310) 773-9781

12121 Wilshire Blvd
Ste 1111
West Los Angeles, CA 90025
Phone (310) 409-4265

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": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1316117104",
    "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": "3820 SEPULVEDA BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905052408",
            "telephone_number": "310-792-5200",
            "fax_number": "310-792-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL VINCENT LAUREOLA DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "LAUREOLA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-792-5200",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "55121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAGICLAND DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MAGICLAND DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.