Active NPI
Maryam M. Afifi, DMD, MS
- Dentist
- Chino, CA
National Provider Identifier
1386017002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 64904
- Practice address
- 12850 10TH St Ste B1
Chino, CA 91710-4297 - Phone
- (909) 613-0111
- NPI assigned
- Nov 3, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 64904 | CA | Primary |
Addresses
Primary practice location
12850 10TH St Ste B1
Chino, CA 91710-4297
Mailing address
7551 Dartmouth Ave
Rancho Cucamonga, CA 91730-1509
Phone (909) 476-8184
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64904 | CA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tareq M. Afifi, D.D.S., Inc. | 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.
-
- General Practice Dentistry
- Chino, CA
- NPI 1659744803
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446768000000",
"number": "1386017002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7551 DARTMOUTH AVE",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917301509",
"telephone_number": "909-476-8184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12850 10TH ST STE B1",
"city": "CHINO",
"state": "CA",
"postal_code": "917104297",
"telephone_number": "909-613-0111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AFIFI",
"first_name": "MARYAM",
"middle_name": "M.",
"credential": "DMD, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-03",
"last_updated": "2015-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "64904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.