NPIMap

Organization Active NPI

Farid Pakravan Professional Dental Corporation

  • General Practice Dentistry
  • Santa Fe Springs, CA
National Provider Identifier
1811614399
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FARID PAKRAVAN PROFESSIONAL DENTAL CORPORATION
Doing business as
MAGICLAND DENTAL GROUP OF SANTA FE SPRINGS
Practice address
10639 Carmenita Rd Unit 7
Santa Fe Springs, CA 90670-4017
Phone
(310) 820-9933
NPI assigned
Oct 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
Miguel Reyes
Title
Credentialing Manager
Phone
(310) 409-4225

Specialties & licenses 1

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

Addresses

Primary practice location

10639 Carmenita Rd Unit 7
Santa Fe Springs, CA 90670-4017

Mailing address

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

Other names 1

  • MAGICLAND DENTAL GROUP OF SANTA FE SPRINGS 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

10639 Carmenita Rd
Unit 7
Santa Fe Springs, CA 90670

NPI Registry JSON

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1811614399",
    "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": "10639 CARMENITA RD UNIT 7",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906704017",
            "telephone_number": "310-820-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARID PAKRAVAN PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_title_or_position": "CREDENTIALING 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": "MAGICLAND DENTAL GROUP OF SANTA FE SPRINGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Fe Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.