Pakravan, Manavi Adn Cohen Dental- San Joe PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PAKRAVAN, MANAVI ADN COHEN DENTAL- SAN JOE PC

Doing business as

Life Connection Health Center

Practice address

3571 N 1St St Ste 203
San Jose, CA 95134-1803

Phone

(408) 424-2200

Fax

(408) 770-1874

NPI assigned

Aug 7, 2018

Organization subpart

No

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

Authorized official

Name

Miguel Reyes

Title

Q/a Contract & Compliance Manager

Phone

(310) 820-9933

Specialties & licenses 1

Addresses

Other names 1

• LIFE CONNECTION HEALTH CENTER Doing business as

Practitioners 1

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

• Henry Vuong Nguyen

  • Dental Hygienist
  • San Jose, CA
  • NPI 1215444120
  NPD (past)

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656288000000",
    "number": "1487133989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 WILSHIRE BLVD STE 1111",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251188",
            "telephone_number": "310-409-4225",
            "fax_number": "310-820-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3571 N 1ST ST STE 203",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951341803",
            "telephone_number": "408-424-2200",
            "fax_number": "408-770-1874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAKRAVAN, MANAVI ADN COHEN DENTAL- SAN JOE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-07",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_title_or_position": "Q/A CONTRACT  & COMPLIANCE MANAGER",
        "authorized_official_telephone_number": "310-820-9933"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIFE CONNECTION HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LIFE CONNECTION HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cathrine Jeesun Pak
• Chong Pak, D.D.S.
• Chonghoon Pak
• Erica Pak
• Johnathan P. Pak, M.D.
• Benjamin Guerrero Palacio III
• Palacios Therapeutic Services
• Russell L Palacios-Balverda
• Eric Jacob Palacios
• Jeralyn Gladys Palacios

• Dentist in San Jose, CA
• Providers in San Jose, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.