Individual provider Active NPI

Robert Richard Iannello, DDS

  • Dentist
  • Moreno Valley, CA
National Provider Identifier
1598851511
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
33101 Issued in CA
Practice address
23940 Ironwood Ave
Suite C
Moreno Valley, CA 92557-7154
Phone
(951) 242-4000
Fax
(951) 242-0511
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 33101 CA Primary

Addresses

Primary practice location

23940 Ironwood Ave
Suite C
Moreno Valley, CA 92557-7154

Mailing address

23940 Ironwood Ave
Suite C
Moreno Valley, CA 92557-7154
Phone (951) 242-4000

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

State licenses

LicenseStateTypeSpecialty
33101CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert R. Iannello, DDS, 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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598851511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23940 IRONWOOD AVE",
            "address_2": "SUITE C",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577154",
            "telephone_number": "951-242-4000",
            "fax_number": "951-242-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23940 IRONWOOD AVE",
            "address_2": "SUITE C",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577154",
            "telephone_number": "951-242-4000",
            "fax_number": "951-242-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNELLO",
        "first_name": "ROBERT",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "33101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.