M Nosrati Dental Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

53932 Issued in CA

Legal business name

M NOSRATI DENTAL CORPORATION

Practice address

13677 Foothill Blvd Ste M
Fontana, CA 92335-0214

Phone

(909) 330-2273

NPI assigned

Nov 6, 2017

Organization subpart

No

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

Authorized official

Name

Mahin Nosrati-Jahromi, DDS

Title

Owner Dentist

Phone

(909) 330-2273

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642723200000",
    "number": "1750894374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13677 FOOTHILL BLVD STE M",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923350214",
            "telephone_number": "909-330-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13677 FOOTHILL BLVD STE M",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923350214",
            "telephone_number": "909-330-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M NOSRATI DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-06",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "NOSRATI-JAHROMI",
        "authorized_official_first_name": "MAHIN",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "909-330-2273",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "53932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Huy Gia Ly, RPH
• Nhieu T Ly, CRNA
• Tauna Hong Ly, PHARM D.
• Cylest Lyles, LMFT
• Sara Alyssa Lynch
• Maagboy Enterprise LLC
• Hisham Maassarani, CRNA
• Andrew Ellis Macelroy Jr., RN
• Alan Enrique Machado, DDS
• Diane Macias

• Dental Clinic/Center in Fontana, CA
• Providers in Fontana, 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 Jan 21, 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.