Douglas Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DOUGLAS DENTAL CORPORATION

Doing business as

Noho Modern Dentistry Dental Group

Practice address

10930 Magnolia Blvd
North Hollywood, CA 91601-3903

Phone

(818) 616-7817

Fax

(818) 638-9608

NPI assigned

Oct 14, 2022

Last updated

Oct 14, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jordan Chelsey Douglas, DDS

Title

Owner

Phone

(818) 616-7817

Specialties & licenses 1

Addresses

Other names 1

• Noho Modern Dentistry Dental Group Doing business as

Practitioners 1

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.

• Kayla Jessie Elizabeth Clokie, DDS

  • General Practice Dentistry
  • North Hollywood, CA
  • NPI 1124879978
  NPD

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1598481228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10930 MAGNOLIA BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916013903",
            "telephone_number": "818-616-7817",
            "fax_number": "818-638-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-08",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "CHELSEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-616-7817",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Noho Modern Dentistry Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heydi Raquel Donaire, M.S.
• Jeff Donavan, CADC-II
• John A Dos Santos
• Double a Hospice
• Sahar Douek, M.D.
• Jenny Marie Downes
• Dr Amir and Dr Hamer Dental (Dental Planet)
• Dr Daniel Boudaie DMD Inc
• Dr Fuscaldos Health and Wellness Center Inc
• Dr Julian Gershfeld Family Dental Group

• General Practice Dentistry in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.