MASTOUR & FARD DENTAL CORP (NPI# 1548730450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548730450 |
| Entity Type | Organization |
| Organization Name | MASTOUR & FARD DENTAL CORP |
| Other Organization Name | COMMUNITY DENTAL GROUP, INC. |
| Practice Address |
587 N. Ventu Park Road. Suite C Newberry Park CA 91320 |
| Mailing Address |
5620 Sawtelle Blvd Culver City CA 90230-5508 |
| Practice Telephone | 8054991253 |
| Practice Fax Number | 8054991453 |
| Mailing Telephone | 3103906212 |
| Mailing Fax Number | 3103906215 |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2019-10-23 |
| Authorized Official Name | PEDRAM MASTOUR (OWNER) |
| Authorized Official Telephone | 3108040414 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | Managed Care Organizations |
| Other Name | Type Code |
|---|---|
| Community Dental Group, Inc. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750848776 | Mastour & Fard Dental Corp | Clinic/Center | 587 N Ventu Park Rd Ste C, Newbury Park, CA 91320-2743 | 2019-02-26 |
| Street Address |
587 N. VENTU PARK ROAD. SUITE C |
| City | NEWBERRY PARK |
| State | CA |
| Zip Code | 91320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235691452 | Velvet Hearts Professional Home Care Agency LLC | Chore Provider | 409 Calle Veracruz, Newbury Park, CA 91320 | 2019-04-05 |
| 1235603325 | Jefix LLC | Durable Medical Equipment & Medical Supplies | 1351 Alessandor Drive, Newberry Park, CA 91320 | 2019-01-11 |
| 1972074987 | Ayreen Sonbol | Non-emergency Medical Transport (VAN) | 79 N Madrid Ave, Newbury Park, CA 91320 | 2018-12-17 |
| 1750874996 | Lady Mary Lhaine Escoto Sagun | Registered Nurse | 1550 Pachino Circle Apt G, Thousand Oaks, CA 91320 | 2018-06-12 |
| 1528410784 | Cristina Rose Markiewicz | Dentist | 400 S. Reino Road, Suite 100, Newbury Park, CA 91320 | 2016-07-12 |
| 1639559552 | Joshua Tree Healthcare, Inc. | Home Health | 2545 W Hillcrest Dr Ste 130a, Thousand Oaks, CA 91320 | 2015-06-05 |
| 1841679651 | Vesper Healthcare, Inc. | Hospice Care, Community Based | 2545 W Hillcrest Dr Ste 130, Thousand Oaks, CA 91320 | 2015-05-26 |
| 1376952580 | Lori Diamond | Pharmacist | 512 Ventu Park Rd, Thousand Oaks, CA 91320 | 2014-08-13 |
| 1275942807 | J J Abbott Dds, PC | Dentist | 501-i S. Reino Rd #214, Newbury Park, CA 91320 | 2014-08-07 |
| 1285054353 | Catherine Dorsey | Social Worker | 863 Tupelo Wood Court, Thousand Oaks, CA 91320 | 2014-04-16 |
| Find all providers in zip 91320 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
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| 1528591476 | Harpreet S. Gill Dds | Preferred Provider Organization | 360 W Foothill Pkwy, Suite 103, Corona, CA 92882-8546 | 2017-04-07 |
| Find all providers with the same taxonomy | ||||
| City | NEWBERRY PARK |
| Zip Code | 91320 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.