FONTANA DENTAL CLINIC (NPI# 1639476765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639476765 |
| Entity Type | Organization |
| Organization Name | FONTANA DENTAL CLINIC |
| Practice Address |
16989 Valley Blvd Suite B Fontana CA 92335-6806 |
| Practice Telephone | 9098293535 |
| Practice Fax Number | 9098298557 |
| Mailing Telephone | 9098293535 |
| Mailing Fax Number | 9098298557 |
| Enumeration Date | 2011-02-25 |
| Last Update Date | 2011-02-25 |
| Authorized Official Name | JOSE ALFREDO VELAZQUEZ (PRESIDENT) |
| Authorized Official Telephone | 9098293535 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
44119 | CA | Dental Providers |
| Street Address |
16989 VALLEY BLVD SUITE B |
| City | FONTANA |
| State | CA |
| Zip Code | 92335-6806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1790312791 | Trevor Nguyen | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd, Building A, Fontana, CA 92335 | 2020-03-27 |
| 1184251365 | Benjamin Chang | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd., Bldg. A, Fontana, CA 92335 | 2020-03-26 |
| 1407487309 | Perla Hernandez | Licensed Vocational Nurse | 14677 Merrill Aver, Fontana, CA 92335 | 2020-01-29 |
| 1013552660 | Valencia Malone | Licensed Vocational Nurse | 14677 Merrill, Fontana, CA 92335 | 2019-11-07 |
| 1831749779 | Daniel Eric Wright | Student in an Organized Health Care Education/Training Program | 14677 Merrell Ave., Fontana, CA 92335 | 2019-09-12 |
| 1962069815 | Melissa Rivera | Licensed Vocational Nurse | 15217 San Bernardino Ave., Fontana, CA 92335 | 2019-05-28 |
| 1275199770 | Jennifer Lynn Malone | Peer Specialist | 14677 Merrall Ave, Fontana, CA 92335 | 2019-05-10 |
| 1770147894 | Noelle Chong | Registered Nurse | 14677 Merill Ave, Fontana, CA 92335 | 2019-04-24 |
| 1992261929 | Destiny Alzate | Counselor | 1467 Merrill Ave, Fontana, CA 92335 | 2019-02-14 |
| Find all providers in zip 92335 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811462369 | Jo-ann De Jesus Africa Dds Inc | Dentist | 15375 Baseline Ave Ste 5, Fontana, CA 92336-5774 | 2018-10-11 |
| 1285137729 | Hoa Nguyen, Dmd, Inc | Dentist | 9190 Sierra Ave Ste 101, Fontana, CA 92335-8613 | 2018-03-12 |
| 1316469885 | Olga Leizerovitz | Dentist | 7426 Cherry Ave Ste 250, Fontana, CA 92336-4221 | 2017-07-16 |
| 1295275642 | Mikaela Benlulu | Dentist | 9193 Sierra Ave Ste A, Fontana, CA 92335-4776 | 2017-03-06 |
| 1982067229 | Youngkwun Kim Dds Inc | Dentist | 8110 Mango Ave Ste 101, Fontana, CA 92335-3603 | 2016-04-04 |
| 1053778241 | Maria Kim | Dentist | 16475 Sierra Lakes Pkwy, 140, Fontana, CA 92336-1259 | 2016-01-20 |
| 1104176817 | Mauricio Dossantos | Dentist | 11201 Sierra Ave Ste 1f, Fontana, CA 92337-7581 | 2012-09-11 |
| 1992079230 | Ivan V. Madzarevic | Dentist | 8990 Sierra Ave., #f, Fontana, CA 92335 | 2012-03-05 |
| 1770879439 | Daniel Wonil Hwang Dds,inc | Dentist | 17695 Arrow Blvd Ste J, Fontana, CA 92335-4041 | 2011-06-21 |
| 1487953949 | Maria Virginia Bravo-espinoza | Dentist | 16147 Foothill Blvd, A, Fontana, CA 92335-0000 | 2011-03-23 |
| Find all providers in FONTANA | ||||
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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.