NPIMap

Organization Active NPI

Cohen Sedgh, Manavi & Pakravan Dental Corporation

Doing business as West Coast Dental Group of Rialto

  • Dentist
  • Rialto, CA
National Provider Identifier
1902402456
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
COHEN SEDGH, MANAVI & PAKRAVAN DENTAL CORPORATION
Doing business as
West Coast Dental Group of Rialto
Practice address
1315 Renaissance Pkwy Ste 870
Rialto, CA 92376-2406
Phone
(310) 820-9933
Fax
(310) 820-0408
NPI assigned
Dec 9, 2020
Last updated
Dec 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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
Dentist 122300000X Primary

Addresses

Primary practice location

1315 Renaissance Pkwy Ste 870
Rialto, CA 92376-2406

Mailing address

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

Other names 1

  • WEST COAST DENTAL GROUP OF RIALTO Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pakravan Dental Corporation23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Locations

1315 Renaissance Pkwy
Rialto, CA 92376
Phone (909) 434-1000

NPI Registry JSON

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1902402456",
    "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",
            "fax_number": "310-820-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 RENAISSANCE PKWY STE 870",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923762406",
            "telephone_number": "310-820-9933",
            "fax_number": "310-820-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COHEN SEDGH, MANAVI & PAKRAVAN DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "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": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WEST COAST DENTAL GROUP OF RIALTO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rialto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.