Organization Active NPI

Javid Dental Corporation

Doing business as Dr. Smile

  • Oral and Maxillofacial Surgery Clinic/Center
  • Torrance, CA
National Provider Identifier
1932650322
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
Legal business name
JAVID DENTAL CORPORATION
Doing business as
Dr. Smile
Practice address
24667 Crenshaw Blvd Ste D
Torrance, CA 90505-5360
Phone
(310) 325-8555
NPI assigned
Oct 20, 2016
Last updated
Jul 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Authorized official

Name
Kayvon JavidNPI 1073697348
Title
Owner
Phone
(310) 325-8555

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X NU Primary
General Practice Dentistry 1223G0001X 48617 CA

Addresses

Primary practice location

24667 Crenshaw Blvd Ste D
Torrance, CA 90505-5360

Mailing address

24667 Crenshaw Blvd Ste D
Torrance, CA 90505-5360
Phone (310) 325-8555

Other identifiers 1

IdentifierTypeStateIssuer
1629413547OtherCANPI

Other names 1

  • Dr. Smile Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220602002099 CA Part B Supplier - Clinic/Group Practice 2466830427 Receives reassigned benefits from 1 practitioner
Practice locations: Torrance, CA

National Provider Directory

National Provider Directory

Locations

2104 Pacific Coast Hwy
Ste 5
Lomita, CA 90717
Phone (310) 325-8555

Practitioners & affiliated clinicians

Practitioners 1

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": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1932650322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24667 CRENSHAW BLVD STE D",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055360",
            "telephone_number": "310-325-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24667 CRENSHAW BLVD STE D",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055360",
            "telephone_number": "310-325-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAVID DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-20",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "JAVID",
        "authorized_official_first_name": "KAYVON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-325-8555"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48617",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1629413547",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Smile",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dr. Smile",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.