NPIMap

Organization Active NPI

Farhad Manavi Professional Dental Corporation

Doing business as West Coast Dental Group of East Los Angeles

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1356565758
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38558 Issued in CA
Legal business name
FARHAD MANAVI PROFESSIONAL DENTAL CORPORATION
Doing business as
West Coast Dental Group of East Los Angeles
Practice address
5162 East Whittier Blvd
Los Angeles, CA 90022
Phone
(323) 415-6161
Fax
(323) 415-0675
NPI assigned
Apr 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Farhad Manavi
Title
Owner
Phone
(323) 415-6161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 38558 CA Primary

Addresses

Primary practice location

5162 East Whittier Blvd
Los Angeles, CA 90022

Mailing address

5162 East Whittier Blvd
Los Angeles, CA 90022
Phone (323) 415-6161

Other names 1

  • WEST COAST DENTAL GROUP OF EAST LOS ANGELES Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Farhad Manavi Professional 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

5162 Whittier Blvd
Los Angeles, CA 90022
Phone (323) 415-6161

Practitioners & affiliated clinicians

Practitioners 11

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": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356565758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5162 EAST WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90022",
            "telephone_number": "323-415-6161",
            "fax_number": "323-415-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5162 EAST WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90022",
            "telephone_number": "323-415-6161",
            "fax_number": "323-415-0675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARHAD MANAVI PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANAVI",
        "authorized_official_first_name": "FARHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-415-6161"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WEST COAST DENTAL GROUP OF EAST LOS ANGELES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.