Individual provider Active NPI

Ronia Ali Blanco

  • Dentist
  • Corona, CA
National Provider Identifier
1073357695
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
111343 Issued in CA
Practice address
3955 Bedford Canyon Rd Unit 101
Corona, CA 92883-3627
Phone
(951) 339-1946
NPI assigned
Jun 19, 2024
Last updated
May 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 111343 CA Primary

Addresses

Primary practice location

3955 Bedford Canyon Rd Unit 101
Corona, CA 92883-3627

Mailing address

3955 Bedford Canyon Rd Unit 101
Corona, CA 92883-3627

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250905003863 CA Order and Referring Only - DentistPractitioner - Dentist 4183126410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111343CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Roquiz and Dhama Dental Corporation CurrentSince Jun 3, 2025 Accepting new patients
Mekhael Dental PLLC PastSince Jul 22, 2025 Accepting new patients

Locations

3955 Bedford Canyon Rd
Unit 101
Corona, CA 92883
Phone (951) 339-1946

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1073357695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 BEDFORD CANYON RD UNIT 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928833627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 BEDFORD CANYON RD UNIT 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928833627",
            "telephone_number": "951-339-1946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI BLANCO",
        "first_name": "RONIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "111343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.