Individual provider Active NPI

Graciela Duran, R.D.H.

  • Dental Hygienist
  • Fontana, CA
National Provider Identifier
1194951509
Registry record updated Jun 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
23478 Issued in CA
Practice address
16135 Sierra Lakes Pkwy
Fontana, CA 92336-1248
Phone
(909) 356-2006
NPI assigned
Jun 1, 2009
Last updated
Jun 1, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 23478 CA Primary

Addresses

Primary practice location

16135 Sierra Lakes Pkwy
Fontana, CA 92336-1248

Mailing address

2177 W Washington Ave
San Bernardino, CA 92411-1051
Phone (951) 203-5414

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

NPI Registry JSON

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243814400000",
    "number": "1194951509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2177 W WASHINGTON AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111051",
            "telephone_number": "951-203-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16135 SIERRA LAKES PKWY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361248",
            "telephone_number": "909-356-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURAN",
        "first_name": "GRACIELA",
        "name_prefix": "Miss",
        "credential": "R.D.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2009-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "23478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; 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.