R. Misner Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

51044 Issued in CA

Legal business name

R. MISNER DENTAL CORPORATION

Practice address

1000 E Palmer Ave
Glendale, CA 91205-3532

Phone

(818) 244-5052

NPI assigned

Feb 5, 2008

Organization subpart

No

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

Authorized official

Name

Shaun Urbanozo

Title

Credentialing Manager

Phone

(719) 323-2362

Specialties & licenses 1

Addresses

Other names 3

• Kids Dental Place Doing business as
• kids and family dental place Doing business as
• Armenian Bayramyan Dental Corp Former legal business name

Locations

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1891973533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 E BIJOU ST STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809098009",
            "telephone_number": "818-244-5052",
            "fax_number": "818-956-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PALMER AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912053532",
            "telephone_number": "818-244-5052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "418 E Glenoaks Blvd",
            "address_2": "202",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912072014",
            "country_code": "US",
            "telephone_number": "818-244-5052",
            "fax_number": "818-956-6098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "R. MISNER DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "URBANOZO",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "719-323-2362"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids Dental Place",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "kids and family dental place",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Armenian Bayramyan Dental Corp",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• All providers in Glendale, CA
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.