MG Reyes Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MG REYES DENTAL CORPORATION

Practice address

14323 Ramona Blvd
Baldwin Park, CA 91706-3242

Phone

(626) 962-8160

NPI assigned

Jul 31, 2019

Organization subpart

Yes

Parent organization

SAN GABRIEL DENTAL PRACTICEAs reported in NPPES

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

Authorized official

Name

Dr. Martin G Reyes

Title

Owner

Phone

(626) 962-8160

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• MG Reyes Dental Corporation Doing business as

Electronic endpoints 2

Part of

San Gabriel Dental Practice

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• San Gabriel Dental Practice

  • Dental Clinic/Center
  • Montebello, CA
  • NPI 1912300427
  NPPES parent name

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575849600000",
    "number": "1881248417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14323 RAMONA BLVD",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063242",
            "telephone_number": "626-962-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14323 RAMONA BLVD",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063242",
            "telephone_number": "626-962-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MG REYES DENTAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN GABRIEL DENTAL PRACTICE",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-962-8160",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619184223",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "1619184223",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "1619184223",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "OUTLOOK",
            "affiliation": "N",
            "endpointDescription": "OUTLOOK",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CELL",
            "address_1": "14323 Ramona Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917063242",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "OUTLOOK",
            "affiliation": "N",
            "endpointDescription": "OUTLOOK",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CELL",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OFFICE",
            "address_1": "14323 Ramona Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917063242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MG Reyes Dental Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Martha I. Mercado, MD
• Philip D. Mercado, MD
• Elizabeth Meza, RDA
• Iriz Patricia Meza
• Karina Alexandra Meza, FNP-BC
• Anne Maddocks Michels, MD
• Nichole K. Mihara, MD
• Milagros a Loo DDS Inc
• Sharon Mills, LCSW
• Zin Min, O.D.

• General Practice Dentistry in Baldwin Park, CA
• Providers in Baldwin Park, 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 Dec 9, 2019; 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.