Conwaydentalcorp

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CONWAYDENTALCORP

Doing business as

Graphit Dental

Practice address

4190 Bonita Rd Ste 205
Bonita, CA 91902-1340

Phone

(619) 475-4226

NPI assigned

Mar 10, 2021

Last updated

Sep 26, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Raivyn Marie Conway, DDSNPI 1699258830

Title

Dentist

Phone

(619) 475-4226

Specialties & licenses 1

Addresses

Other names 1

• Graphit Dental Doing business as

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Raivyn Marie Conway, DDS

  • General Practice Dentistry
  • Bonita, CA
  • NPI 1699258830
  Authorized official Same address or phone

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664150400000",
    "number": "1750966925",
    "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"
        },
        {
            "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": {
        "organization_name": "CONWAYDENTALCORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-10",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "CONWAY",
        "authorized_official_first_name": "RAIVYN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "619-475-4226",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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": [
        {
            "organization_name": "Graphit Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carlos O Chacon, M.D.
• Lera A Chernov, M.S. CCC-SLP
• Antoinette Evangelista Colcol, PTA
• Edna Turla Concepcion, DDS
• Raivyn Marie Conway, DDS
• Cordero Chula Vista Sports Chiropractic Apc. Inc.
• Daniel Cordero, D.C., C.S.C.S.
• Alma Maria Cortez
• Pamela Sue Davidson, CNS
• Isaac Jordan Davis, DO

• 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.