Provider Demographics
NPI:1730067737
Name:OCEAN VIEW DENTAL GROUP
Entity type:Organization
Organization Name:OCEAN VIEW DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:LIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-372-8188
Mailing Address - Street 1:500 S SEPULVEDA BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6976
Mailing Address - Country:US
Mailing Address - Phone:310-372-8188
Mailing Address - Fax:310-376-1909
Practice Address - Street 1:500 S SEPULVEDA BLVD STE 210
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6976
Practice Address - Country:US
Practice Address - Phone:310-372-8188
Practice Address - Fax:310-376-1909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental