MK Raymond Dental Corporation PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MK RAYMOND DENTAL CORPORATION PC

Practice address

3130 Union Ave
Bakersfield, CA 93305-3443

Phone

(661) 872-2170

Fax

(818) 773-0911

NPI assigned

Nov 18, 2020

Organization subpart

No

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

Authorized official

Name

M. Kyle Raymond

Title

D.D.S./Owner

Phone

(661) 872-2170

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

MK Raymond Dental Corporation PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• MK Raymond Dental Corporation PC

  • Pediatric Dentistry
  • Chatsworth, CA
  • NPI 1184219909
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• MK Raymond Dental Corporation PC

  • Pediatric Dentistry
  • Chatsworth, CA
  • NPI 1184219909
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward Esser Dove, D.D.S.

  • Pediatric Dentistry
  • Bakersfield, CA
  • NPI 1417981606
  NPD

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1861095226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 UNION AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933053443",
            "telephone_number": "661-872-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 UNION AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933053443",
            "telephone_number": "661-872-2170",
            "fax_number": "818-773-0911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20523 Devonshire St",
            "address_purpose": "LOCATION",
            "city": "Chatsworth",
            "state": "CA",
            "postal_code": "913113208",
            "country_code": "US",
            "telephone_number": "818-773-0911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MK RAYMOND DENTAL CORPORATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-18",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "RAYMOND",
        "authorized_official_first_name": "M.",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "D.D.S./OWNER",
        "authorized_official_telephone_number": "661-872-2170"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA DENTAL LICENSE",
            "identifier": "105526",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gordon Murray Mitts, M.D.
• Siria Anete Miyagishima, NP
• Morgan Miyake
• Maguire Mize
• Leonard Julius Mizrahi, M.D.
• Arsen Vladimir Mkrtchyan, MD
• Mara Mladenovski
• Qanda Debra Mlambo
• MNZ Corporation
• Mostafa Moarefian, PHARMD

• Pediatric Dentistry in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.