Individual provider Active NPI

Osbalda Dominga Reina, DDS

  • Dentist
  • Riverside, CA
National Provider Identifier
1013156793
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
58068 Issued in CA
Practice address
4959 Arlington Ave Ste H
Riverside, CA 92504-2756
Phone
(951) 299-7101
Fax
(951) 299-7101
NPI assigned
Feb 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 58068 CA
Dentist 122300000X 58068 CA Primary

Addresses

Primary practice location

4959 Arlington Ave Ste H
Riverside, CA 92504-2756

Mailing address

4959 Arlington Ave Suite H
Riverside, CA 92504
Phone (951) 299-7101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170421001593 CA Order and Referring Only - General PracticePractitioner - General Practice 7113203407

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
58068CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Osbalda D Reina DDS Inc General Practice Current Accepting new patients

Locations

4959 Arlington Ave
Ste H
Riverside, CA 92504
Phone (951) 299-7101

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1013156793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4959 ARLINGTON AVE SUITE H",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92504",
            "telephone_number": "951-299-7101",
            "fax_number": "951-299-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4959 ARLINGTON AVE STE H",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925042756",
            "telephone_number": "951-299-7101",
            "fax_number": "951-299-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINA",
        "first_name": "OSBALDA",
        "middle_name": "DOMINGA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-19",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58068",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.