Individual provider Active NPI

Alma Delia Coronado, D.A

  • Dental Assistant
  • Riverside, CA
National Provider Identifier
1114225349
Registry record updated Mar 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
08-5808 Issued in CA
Practice address
3380 La Sierra Ave Ste 108
Riverside, CA 92503-5225
Phone
(951) 354-9999
NPI assigned
Mar 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X 08-5808 CA Primary

Addresses

Primary practice location

3380 La Sierra Ave Ste 108
Riverside, CA 92503-5225

Mailing address

324 Le Borgne Ave
La Puente, CA 91746-2307
Phone (626) 272-7404

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

State licenses

LicenseStateTypeSpecialty
08-5808CAMDDental Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cohen Sedgh, Manavi & Pakravan Dental Corp Past Accepting new patients

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": "1299888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299888000000",
    "number": "1114225349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 LE BORGNE AVE",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917462307",
            "telephone_number": "626-272-7404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 LA SIERRA AVE STE 108",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035225",
            "telephone_number": "951-354-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONADO",
        "first_name": "ALMA",
        "middle_name": "DELIA",
        "credential": "D.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-12",
        "last_updated": "2011-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "CA",
            "license": "08-5808",
            "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 Mar 12, 2011; 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.