MLD Dental Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

49141 Issued in CA

Legal business name

MLD DENTAL INC

Practice address

9448 Magnolia Ave
Riverside, CA 92503-3700

Phone

(951) 343-0123

Fax

(714) 984-0246

NPI assigned

Sep 29, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Mathew T Luu, DDS

Title

Dentist

Phone

(714) 261-4243

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Chapman Smiles Center Doing business as

Locations

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506643200000",
    "number": "1689183907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 W CHAPMAN AVE STE 107",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682331",
            "telephone_number": "714-829-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9448 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033700",
            "telephone_number": "951-343-0123",
            "fax_number": "714-984-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLD DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-29",
        "last_updated": "2017-09-29",
        "status": "A",
        "authorized_official_last_name": "LUU",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "714-261-4243",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "49141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G9363301",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chapman Smiles Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Riverside, CA
• Providers in Riverside, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2017; 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.