Redford Menifee Dental Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

REDFORD MENIFEE DENTAL CORPORATION

Doing business as

Legacy Dental of Menifee

Practice address

27701 Scott Rd Ste 107
Menifee, CA 92584-9434

Phone

(951) 301-6100

NPI assigned

Mar 8, 2023

Organization subpart

No

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

Authorized official

Name

Valerie Rogers

Title

Office Manager

Phone

(951) 677-5113

Specialties & licenses 1

Addresses

Other names 1

• Legacy Dental of Menifee Doing business as

Practitioners 1

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

• Jacob Tucker Barton, DDS

  • General Practice Dentistry
  • Menifee, CA
  • NPI 1619649092
  NPD

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678233600000",
    "number": "1316647241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27701 SCOTT RD STE 107",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925849434",
            "telephone_number": "951-301-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27701 SCOTT RD STE 107",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925849434",
            "telephone_number": "951-301-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDFORD MENIFEE DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "951-677-5113"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Dental of Menifee",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Safeer Nehaal Rasul, DDS
• Evan M Ravely, PTA
• Jennifer Ravely, P.T.A.
• Anam Asif Raza, DMD
• Dylan Reaves
• Tamia Jade Redmon
• Silvia Reid, NP
• Sally Reiter
• Amber Remaly
• Lauren Michelle Reminger, LMFT

• Dental Clinic/Center in Menifee, CA
• Providers in Menifee, CA by specialty
• Dental Clinic/Center in California

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