Beverly Sharon Sotto Fontejon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53651 Issued in CA

Practice address

223 W San Bernardino Rd
Covina, CA 91723-1516

Phone

(626) 339-1180

Fax

(626) 339-2280

NPI assigned

Jan 16, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Celia P. Octoman, DMD, Inc.

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1750431516
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255482170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19123 AMBER VALLEY DR",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917894180",
            "telephone_number": "626-893-3589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 W SAN BERNARDINO RD",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231516",
            "telephone_number": "626-339-1180",
            "fax_number": "626-339-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTEJON",
        "first_name": "BEVERLY SHARON",
        "middle_name": "SOTTO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fulviu Mihai Fodoreanu, PSYD
• Diamond Rae Fonder
• Olivia Fondjo
• Ansel Fong
• Karyme Victoria Fonseca
• Jennifer Marlene Foote-Nalbach, Psy.D., PSY.D.
• Foothill Care Center II, LLC
• Foothill Care Center II, LLC
• Foothill Family Service
• Foothills Pain Management Clinic PC

• General Practice Dentistry in Covina, CA
• Providers in Covina, CA by specialty
• General Practice Dentistry in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.