Mandara 3 PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MANDARA 3 PLLC

Practice address

1908 Central Dr Ste D
Bedford, TX 76021-5822

Phone

(817) 285-5880

NPI assigned

Nov 15, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Bhavik Mohanlal, DMDNPI 1134893233

Title

Dentist

Phone

(972) 951-0470

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Lifetime Mobile Dental Doing business as

Electronic endpoints 1

Locations

Practitioners 1

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

• Bhavik Mohanlal, DMD

  • General Practice Dentistry
  • Bedford, TX
  • NPI 1134893233
  NPD Authorized official

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1427767755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 STENNETT DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760062807",
            "telephone_number": "972-951-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 CENTRAL DR STE D",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215822",
            "telephone_number": "817-285-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANDARA 3 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-15",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "MOHANLAL",
        "authorized_official_first_name": "BHAVIK",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "972-951-0470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134893233",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427767755",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bhavik@lifetimemobiledental.com",
            "affiliation": "N",
            "endpointDescription": "Info transfer",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1908 Central Dr Ste D",
            "city": "Bedford",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760215822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lifetime Mobile Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lifetime Mobile Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberlee Anne Main Munoz, LMSW
• Rida Malik
• Saad Javed Malik, M.D.
• Mamo LLC
• Manchester Interventional Pain Center LLC
• Cara Mandeville
• Joseph Mansen, M.D.
• Kanza Mirza Maqsood, MD
• Mark Edward Scroggins, M.D. P.a.
• Steven Marker

• Dental Clinic/Center in Bedford, TX
• Providers in Bedford, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.