Pakravan, Manavi & Cohen Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PAKRAVAN, MANAVI & COHEN DENTAL CORPORATION

Doing business as

Magicland Dental Group of Rialto

Practice address

1205 W Renaissance Pkwy
Suite 240
Rialto, CA 92376

Phone

(310) 820-9933

Fax

(310) 820-0408

NPI assigned

Aug 20, 2018

Last updated

Jul 30, 2020By the provider in NPPES

Organization subpart

No

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) 820-9933

Specialties & licenses 1

Addresses

Other names 1

• MAGICLAND DENTAL GROUP OF RIALTO Doing business as

Locations

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.

• Marian Tzu Miao Lin, D.D.S.

  • General Practice Dentistry
  • Rialto, CA
  • NPI 1275521072
  NPD (past)

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1942780853",
    "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": "310-409-4225",
            "fax_number": "310-820-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 W RENAISSANCE PKWY",
            "address_2": "SUITE 240",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "92376",
            "telephone_number": "310-820-9933",
            "fax_number": "310-820-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAKRAVAN, MANAVI & COHEN DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-20",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "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": "310-820-9933"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAGICLAND DENTAL GROUP OF RIALTO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pacific Clinics
• Marissa Renee Padilla
• Yesenia Padilla
• Editha Padua, RN
• Michelle Renee Paez
• Cristina Renee Palmer
• Tamika Palmer
• Paniagua DDS a Dental Corporation (Dental Care of Rialto)
• Catherine M Pantig, PT
• Paramount Medical, Inc.

• General Practice Dentistry in Rialto, CA
• Providers in Rialto, 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 Jul 30, 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.