NPIMap

Organization Active NPI

Bravo Dental Corporation

  • Dental Clinic/Center
  • Anaheim, CA
National Provider Identifier
1548094436
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BRAVO DENTAL CORPORATION
Practice address
215 N State College Blvd Ste E
Anaheim, CA 92806-2934
Phone
(714) 635-0892
NPI assigned
Sep 2, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2024

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

Authorized official

Name
Dr. Luz S Bravo, DDSNPI 1437804713
Title
President/Dentist
Phone
(714) 635-0892

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

215 N State College Blvd Ste E
Anaheim, CA 92806-2934

Mailing address

215 N State College Blvd Ste E
Anaheim, CA 92806-2934
Phone (714) 635-0892

National Provider Directory

National Provider Directory

Locations

215 N State College Blvd
Ste E
Anaheim, CA 92806
Phone (714) 635-0892

Practitioners & affiliated clinicians

Practitioners 2

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": "1725235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725235200000",
    "number": "1548094436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N STATE COLLEGE BLVD STE E",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062934",
            "telephone_number": "714-635-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N STATE COLLEGE BLVD STE E",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062934",
            "telephone_number": "714-635-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVO DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-02",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-01",
        "status": "A",
        "authorized_official_last_name": "BRAVO",
        "authorized_official_first_name": "LUZ",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "714-635-0892",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.