Anthony W. Deza, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

42539 Issued in CA

Practice address

2010 N Riverside Ave
Suite a
Rialto, CA 92377-4652

Phone

(909) 421-1555

Fax

(909) 421-1865

NPI assigned

Oct 17, 2007

Last updated

Oct 17, 2007By the provider in NPPES

Sex

Male

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• DRS Villarroel & Villarroel DDS Inc

  • Dentist
  • Rialto, CA
  • NPI 1861771271
  NPD (past)
• Rancho Dental Office

  • Dental Clinic/Center
  • Rialto, CA
  • NPI 1750576096
  NPD (past)

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1467641159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26990 KALMIA AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925551914",
            "telephone_number": "951-924-6182",
            "fax_number": "951-924-6182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 N RIVERSIDE AVE",
            "address_2": "SUITE A",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923774652",
            "telephone_number": "909-421-1555",
            "fax_number": "909-421-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEZA",
        "first_name": "ANTHONY",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "42539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Department of Behavioral Health, San Bernardino County Ca (Agewise)
• Department of Behaviour Health, SB County
• Designer Dentistry Group of Rialto
• Desired Change Therapeutic Solutions a Licensed Clinical Social Worker (Desired Change Therapeutic Solutions)
• Lekha Devasirbatham
• Eunice Ezinne Diabuah
• Diakonia Incorporation
• Diakonia, Inc. (Maywright Boys Home)
• Diakonia, Inc. (Home of Excellence)
• Diakonia, Inc. (Achieve Residential Center)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.