NPIMap

Organization Active NPI

Farid Pakravan Professional Dental Corporation

  • Pediatric Dentistry
  • North Hollywood, CA
National Provider Identifier
1780396796
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
FARID PAKRAVAN PROFESSIONAL DENTAL CORPORATION
Doing business as
MAGICLAND CHILDREN'S DENTISTRY & ORTHODONTICS DENTAL GROUP
Practice address
6423 Vineland Ave
North Hollywood, CA 91606-2712
Phone
(310) 820-9933
Fax
(310) 820-0408
NPI assigned
Dec 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 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
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

6423 Vineland Ave
North Hollywood, CA 91606-2712

Mailing address

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

Other names 1

  • MAGICLAND CHILDREN'S DENTISTRY & ORTHODONTICS DENTAL GROUP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Farid Pakravan Professional 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

6423 Vineland Ave
North Hollywood, CA 91606
Phone (818) 432-2199

6415 Vineland Ave
North Hollywood, CA 91606

NPI Registry JSON

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1780396796",
    "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": "6423 VINELAND AVE",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916062712",
            "telephone_number": "310-820-9933",
            "fax_number": "310-820-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARID PAKRAVAN PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-21",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "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": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAGICLAND CHILDREN'S DENTISTRY & ORTHODONTICS DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.