Warisara Srimuang

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

H8696 Issued in OR

Practice address

10470 Foothill Blvd Ste 126
Rancho Cucamonga, CA 91730-6945

Phone

(909) 989-7888

NPI assigned

Jul 16, 2024

Last updated

Jul 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• F.R Edalatpajouh Dental Inc

  • Dental Clinic/Center
  • Rancho Cucamonga, CA
  • NPI 1538976204
  NPD
• Dr Albert Lee DDS. Inc.

  • General Practice Dentistry
  • Rancho Cucamonga, CA
  • NPI 1740350925
  NPD (past)

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1063250827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5895 CEDAR MOUNTAIN DR",
            "city": "ALTA LOMA",
            "state": "CA",
            "postal_code": "917377840",
            "telephone_number": "626-689-9212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10470 FOOTHILL BLVD STE 126",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306945",
            "telephone_number": "909-989-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIMUANG",
        "first_name": "WARISARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "26239",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H8696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Spivack, M.D.
• Katelynn Spoerhase
• Alisha Springer
• Spruce Surgery Center LLC
• Christopher Spurgeon, D.D.S.
• SRK Clinic
• St. Augustine Hospice, Inc.
• St. Francis Home Health Agency, Inc. (St. Francis Home Health Agency)
• St. Francis Home Health Agency, Inc.
• St. Francis Hospice Care, Inc.

• Dental Hygienist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Dental Hygienist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.