Organization Active NPI

Mann Fortuna Dental, LLC

  • General Practice Dentistry
  • Yuma, AZ
National Provider Identifier
1457948622
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MANN FORTUNA DENTAL, LLC
Practice address
11231 Commercial Center Loop Ste 105
Yuma, AZ 85367-7474
Phone
(928) 783-8300
NPI assigned
Dec 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Authorized official

Name
Asham Deep Kaur
Title
Ceo
Phone
(510) 378-9802

Specialties & licenses 1

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

Addresses

Primary practice location

11231 Commercial Center Loop Ste 105
Yuma, AZ 85367-7474

Mailing address

11231 Commercial Center Loop Ste 105
Yuma, AZ 85367-7474
Phone (928) 783-8300

National Provider Directory

National Provider Directory

Locations

11231 E Commercial Centre Loop
Ste 105
Yuma, AZ 85367
Phone (928) 783-8300

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": "1608595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1457948622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11231 COMMERCIAL CENTER LOOP STE 105",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853677474",
            "telephone_number": "928-783-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11231 COMMERCIAL CENTER LOOP STE 105",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853677474",
            "telephone_number": "928-783-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANN FORTUNA DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-14",
        "status": "A",
        "authorized_official_last_name": "KAUR",
        "authorized_official_first_name": "ASHAM",
        "authorized_official_middle_name": "DEEP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-378-9802"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

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