Ethar Riyadh Al-Wazeer, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

105309 Issued in CA

Practice address

10144 Sierra Ave
Fontana, CA 92335-6725

Phone

(909) 770-7367

NPI assigned

Aug 20, 2020

Last updated

Sep 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1366054348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 ORANGE AVE APT 304",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923731493",
            "telephone_number": "630-408-9723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10144 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356725",
            "telephone_number": "909-770-7367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1510 Orange Ave Apt 304",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923731493",
            "country_code": "US",
            "telephone_number": "630-408-9723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-WAZEER",
        "first_name": "ETHAR",
        "middle_name": "RIYADH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Heyzel Alarcon
• Brandie Bernice Alarrabiyyat, LVN

• Dentist in Fontana, CA
• Providers in Fontana, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.