M.G. Professional Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

46945 Issued in CA

Legal business name

M.G. PROFESSIONAL DENTAL CORPORATION

Doing business as

MGR DENTAL GROUP

Practice address

525 S. Azusa Way
La Puente, CA 91744

Phone

(626) 810-0045

NPI assigned

Aug 17, 2007

Organization subpart

No

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

Authorized official

Name

Mayra Sanchez

Title

Ceo

Phone

(626) 274-0732

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MGR DENTAL GROUP Doing business as

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1659563120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 S. AZUSA WAY",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "91744",
            "telephone_number": "626-810-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S. AZUSA WAY",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "91744",
            "telephone_number": "626-810-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M.G. PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ",
        "authorized_official_first_name": "MAYRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-274-0732"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL PROVIDER",
            "identifier": "G92678-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MGR DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jonathan Luis Luna Ortega
• Malena Olivia Luna
• Dzuy Luu, PA-C
• Kevin Ly
• M Sanchez DDS Dental Inc.
• Mabel B Schneider-Utz D D S a Proffessional Corp.
• Irene Macias Franco, LCSW
• Joanna Macias
• Malini Indra Madhusudhan
• Ryan M Magno, MSW

• General Practice Dentistry in La Puente, CA
• Providers in La Puente, 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 Aug 17, 2007; 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.