NPIMap

Organization Active NPI

F.Pakravan Dental Corporation

Doing business as Dental Group of Clovis

  • General Practice Dentistry
  • Clovis, CA
National Provider Identifier
1508089889
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39862 Issued in CA
Legal business name
F.PAKRAVAN DENTAL CORPORATION
Doing business as
Dental Group of Clovis
Practice address
200 W Shaw Ave
Suite 110
Clovis, CA 93612-3684
Phone
(559) 325-6161
Fax
(559) 325-6166
NPI assigned
Apr 11, 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
Farid Pakravan
Title
Owner
Phone
(559) 325-6161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 39862 CA Primary

Addresses

Primary practice location

200 W Shaw Ave
Suite 110
Clovis, CA 93612-3684

Mailing address

200 W Shaw Ave
Suite 110
Clovis, CA 93612-3684
Phone (559) 325-6161

Other names 1

  • DENTAL GROUP OF CLOVIS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Group of Clovis2 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

200 W Shaw Ave
Ste 110
Clovis, CA 93612
Phone (559) 325-6161

Practitioners & affiliated clinicians

Practitioners 7

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": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508089889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W SHAW AVE",
            "address_2": "SUITE 110",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936123684",
            "telephone_number": "559-325-6161",
            "fax_number": "559-325-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W SHAW AVE",
            "address_2": "SUITE 110",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936123684",
            "telephone_number": "559-325-6161",
            "fax_number": "559-325-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "F.PAKRAVAN DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAKRAVAN",
        "authorized_official_first_name": "FARID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-325-6161"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DENTAL GROUP OF CLOVIS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clovis, 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.