NPIMap

Organization Active NPI

Manavi Dental Corporation

Doing business as West Coast Dental & Orthodontics, Adult & Kids Dental Group

  • General Practice Dentistry
  • Fontana, CA
National Provider Identifier
1689351884
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MANAVI DENTAL CORPORATION
Doing business as
West Coast Dental & Orthodontics, Adult & Kids Dental Group
Practice address
16120 S Highland Ave Ste 300
Fontana, CA 92336-1228
Phone
(310) 820-9933
Fax
(310) 820-0408
NPI assigned
Jun 29, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Authorized official

Name
Miguel Reyes
Title
Q/a Contract & Compliance Manager
Phone
(310) 409-4225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

16120 S Highland Ave Ste 300
Fontana, CA 92336-1228

Mailing address

12121 Wilshire Blvd Ste 1111
Los Angeles, CA 90025-1188
Phone (310) 820-9933

Other names 1

  • WEST COAST DENTAL & ORTHODONTICS, ADULT & KIDS DENTAL GROUP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Manavi Dental Corporation4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

16168 S Highland Ave
Ste 300
Fontana, CA 92336

16120 S Highland Ave
Ste 300
Fontana, CA 92336
Phone (909) 232-8179

NPI Registry JSON

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1689351884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 WILSHIRE BLVD STE 1111",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251188",
            "telephone_number": "310-820-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16120 S HIGHLAND AVE STE 300",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361228",
            "telephone_number": "310-820-9933",
            "fax_number": "310-820-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANAVI DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_title_or_position": "Q/A CONTRACT & COMPLIANCE MANAGER",
        "authorized_official_telephone_number": "310-409-4225"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WEST COAST DENTAL & ORTHODONTICS, ADULT & KIDS DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WEST COAST DENTAL & ORTHODONTICS, ADULT & KIDS DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.