MRS. MITRA BOLBOLAN MACMILLAN (NPI# 1497964514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497964514 |
| Entity Type | Individual |
| Full Name | MRS. MITRA BOLBOLAN MACMILLAN |
| Credential | D.D.S |
| Practice Address |
4264 Green River Rd Corona CA 92880-1669 |
| Practice Telephone | 9513400200 |
| Practice Fax Number | 9512789858 |
| Mailing Telephone | 9513400200 |
| Mailing Fax Number | 9512789858 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
42808 | CA | Dental Providers |
| Street Address |
4264 GREEN RIVER RD |
| City | CORONA |
| State | CA |
| Zip Code | 92880-1669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790258556 | Nguyen Ly Nguy Dental Corp | Dentist | 4264 Green River Rd, Suite 102, Corona, CA 92880 | 2019-01-04 |
| 1538548169 | Singhal Dental Inc | Point of Service | 4264 Green River Rd, Suite # 102, Corona, CA 92880-1632 | 2015-05-28 |
| 1952663676 | Eikerbee, Inc | Pharmacy | 4264 Green River Rd, Suite 101, Corona, CA 92880-1632 | 2012-06-08 |
| 1790931046 | Dental Health Corona | Dentist | 4264 Green River Rd, Corona, CA 92880-1632 | 2008-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568084945 | Eastvale Family Care Inc. | Family Medicine | 14252 Schleisman Rd., Eastvale, CA 92880 | 2020-05-08 |
| 1982226460 | Eastvale Urgent Care Inc | Clinic/Center | 14252 Schleisman Rd, Eastvale, CA 92880 | 2020-05-07 |
| 1578199741 | Corrections and Rehabilitation | Pharmacy | 16756 Chino Corona Road, Corona, CA 92880 | 2020-03-19 |
| 1184274029 | Rocquel Mack | Licensed Vocational Nurse | 2131 Shelley Circle, Corona, CA 92880 | 2019-09-12 |
| 1255993176 | Symbiosis, Inc. | Clinic/Center | 3115 Palisades Drive, Corona, CA 92880 | 2019-07-01 |
| 1770065559 | Kumkum Mehta | Nurse Practitioner | 7391 Sungold Ave, Corona, CA 92880 | 2018-08-29 |
| 1629559802 | Skt Therapy Inc | Marriage & Family Therapist | 765 N Main St Ste 152, Corona, CA 92880 | 2018-08-24 |
| 1356854145 | Hk Durgs Inc | Pharmacy | 13394 Limonite Ave, Ste 120, Eastvale, CA 92880 | 2017-11-15 |
| 1134638653 | National Vision, Inc. | Technician/Technologist | 482 Main Street, Corona, CA 92880 | 2017-09-27 |
| 1922527464 | Crown Care Transportation | Non-emergency Medical Transport (VAN) | 13557 Nectarine Ave, Corona, CA 92880 | 2017-09-15 |
| Find all providers in zip 92880 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285811828 | James C Jun | Dentist | 1760 W 6th St, Corona, CA 92882-2790 | 2008-01-25 |
| 1457564296 | James S Minutello | Dentist | 770 Magnolia Ave Suite 2-e, Corona, CA 92879-3122 | 2007-05-08 |
| 1104048909 | Regina D Minutello | Dentist | 770 Magnolia Ave Ste 2e, Corona, CA 92879-3122 | 2007-05-02 |
| 1912011099 | John Edward Elliott | Dentist | 900 S Main St Ste 104, Corona, CA 92882-3401 | 2006-08-18 |
| 1770703258 | Rasheed Simjee Professional Dental Corp | Dentist | 1810 Fullerton Ave, #205, Corona, CA 92881-3103 | 2007-04-26 |
| 1790899342 | Rasheed Simjee | Dentist | 1810 Fullerton Ave, #205, Corona, CA 92881-3103 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204780 | Richard Koh Dds Ms Inc. | Dentist | 11 Delano, Irvine, CA 92602-2462 | 2020-10-30 |
| 1225641293 | Richard T. Kao, Dds, Phd - Dental Corp. | Dentist | 1660 Willow St Ste 3, San Jose, CA 95125-5101 | 2020-08-28 |
| 1093325722 | Sergio Florencio Jr, Dds, Dmsc, Inc | Dentist | 1802 San Miguel Dr, Walnut Creek, CA 94596-8606 | 2020-08-06 |
| 1205463445 | Sharona Dayan, Dds, Inc | Dentist | 9735 Wilshire Blvd Ste 211, Beverly Hills, CA 90212-2102 | 2020-03-26 |
| 1215573522 | Vanessa Bikhazi | Dentist | 2372 Se Bristol St Ste A, Newport Beach, CA 92660-0755 | 2019-11-21 |
| 1063057008 | Robert Lacrampe | Dentist | 880 W 1st St Apt 526, Los Angeles, CA 90012-2473 | 2019-11-13 |
| 1376194639 | Snow Nakano & Lopez Professional Dental Corporation | Dentist | 868 Auto Center Dr Ste A, Palmdale, CA 93551-4691 | 2019-09-26 |
| 1659926285 | Suman Ramakumar Dds Inc | Dentist | 1171 Homestead Rd Ste 175, Santa Clara, CA 95050-5484 | 2019-08-09 |
| 1912567058 | Andrew Peterson Dmd Ms PC | Dentist | 9856 Hibiscus Ct, Alta Loma, CA 91737-3637 | 2019-06-20 |
| 1124686233 | Danoukh Dental Corp. | Dentist | 12271 La Mirada Blvd Ste 201, La Mirada, CA 90638-1336 | 2019-06-04 |
| Find all providers with the same taxonomy | ||||
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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.