NPIMap

Organization Active NPI

Mantena Dental Corportation

Doing business as Empire Parkway Dental Group

  • General Practice Dentistry
  • Folsom, CA
National Provider Identifier
1316555253
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MANTENA DENTAL CORPORTATION
Doing business as
Empire Parkway Dental Group
Practice address
25005 Blue Ravine Rd Ste 100
Folsom, CA 95630-5706
Phone
(916) 984-8050
NPI assigned
Jul 16, 2020
Last updated
Jul 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Authorized official

Name
Morgan Macdougall
Title
Office Manager
Phone
(916) 599-6767

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

25005 Blue Ravine Rd Ste 100
Folsom, CA 95630-5706

Mailing address

25005 Blue Ravine Rd Ste 100
Folsom, CA 95630-5706
Phone (916) 984-8050

Other names 1

  • Empire Parkway Dental Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594857600000",
    "number": "1316555253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25005 BLUE RAVINE RD STE 100",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956305706",
            "telephone_number": "916-984-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25005 BLUE RAVINE RD STE 100",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956305706",
            "telephone_number": "916-984-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANTENA DENTAL CORPORTATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A",
        "authorized_official_last_name": "MACDOUGALL",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "916-599-6767"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Empire Parkway Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.