Raivyn Marie Conway, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

103216 Issued in CA

Practice address

4190 Bonita Rd Ste 205
Bonita, CA 91902-1340

Phone

(619) 475-4226

NPI assigned

Sep 13, 2018

Last updated

Sep 26, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Conway DDS Inc.

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1659095412
  NPD Authorized official
• Conwaydentalcorp

  dba Graphit Dental

  • General Practice Dentistry
  • Bonita, CA
  • NPI 1750966925
  Authorized official Same address or phone

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1699258830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 BONITA RD STE 205",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919021340",
            "telephone_number": "619-475-4226",
            "fax_number": "619-475-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 BONITA RD STE 205",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919021340",
            "telephone_number": "619-475-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "RAIVYN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.graphitedental.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4190 Bonita Rd Ste 205",
            "city": "Bonita",
            "state": "CA",
            "country_code": "US",
            "postal_code": "919021340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Daniel Cha, O.D.
• Carlos O Chacon, M.D.
• Lera A Chernov, M.S. CCC-SLP
• Antoinette Evangelista Colcol, PTA
• Edna Turla Concepcion, DDS
• Conwaydentalcorp (Graphit Dental)
• Cordero Chula Vista Sports Chiropractic Apc. Inc.
• Daniel Cordero, D.C., C.S.C.S.
• Alma Maria Cortez
• Pamela Sue Davidson, CNS

• General Practice Dentistry in Bonita, CA
• Providers in Bonita, 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 Sep 26, 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.