NPIMap

Organization Active NPI

Simi Childrens Dental Group

  • Pediatric Dentistry
  • Simi Valley, CA
National Provider Identifier
1912020595
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D 44936 Issued in CA
Legal business name
SIMI CHILDRENS DENTAL GROUP
Practice address
1755 Erringer Rd
Suite 20
Simi Valley, CA 93065-6507
Phone
(805) 522-2164
Fax
(805) 522-9849
NPI assigned
Apr 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Nina Mandelman, DDSNPI 1619090214
Title
Partner
Phone
(805) 522-2164

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X D 44936 CA Primary

Addresses

Primary practice location

1755 Erringer Rd
Suite 20
Simi Valley, CA 93065-6507

Mailing address

1755 Erringer Rd
Suite 20
Simi Valley, CA 93065-6507
Phone (805) 522-2164

National Provider Directory

National Provider Directory

Locations

1755 Erringer Rd
Ste 20
Simi Valley, CA 93065
Phone (805) 522-2164

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912020595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 ERRINGER RD",
            "address_2": "SUITE 20",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930656507",
            "telephone_number": "805-522-2164",
            "fax_number": "805-522-9849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 ERRINGER RD",
            "address_2": "SUITE 20",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930656507",
            "telephone_number": "805-522-2164",
            "fax_number": "805-522-9849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMI CHILDRENS DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANDELMAN",
        "authorized_official_first_name": "NINA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "805-522-2164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "D 44936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.