Active NPI
Manuel Humberto Guevara, DDS,MS
- Dentist
- Riverside, CA
National Provider Identifier
1023226594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 52057
- Practice address
- 3679 Arlington Ave
Riverside, CA 92506-3940 - Phone
- (951) 683-1811
- Fax
- (951) 782-0649
- NPI assigned
- May 18, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 52057 | CA | Primary |
Addresses
Primary practice location
3679 Arlington Ave
Riverside, CA 92506-3940
Mailing address
12822 Black Creek CT
Rancho Cucamonga, CA 91739-2621
Phone (909) 646-8858
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52057 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023226594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12822 BLACK CREEK CT",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917392621",
"telephone_number": "909-646-8858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3679 ARLINGTON AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925063940",
"telephone_number": "951-683-1811",
"fax_number": "951-782-0649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUEVARA",
"first_name": "MANUEL",
"middle_name": "HUMBERTO",
"credential": "DDS,MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "52057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.