Healthcare Provider Details

I. General information

NPI: 1417839945
Provider Name (Legal Business Name): MVP SMILES, A DENTAL CORPORATION BY KATERINA KLEINOVA DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 E FOOTHILL BLVD
POMONA CA
91767-1405
US

IV. Provider business mailing address

323 E FOOTHILL BLVD
POMONA CA
91767-1405
US

V. Phone/Fax

Practice location:
  • Phone: 909-284-8841
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VINCENT MOREAU
Title or Position: ADMINISTRATIVE MANAGER
Credential:
Phone: 424-542-2247