Alphonso Raymond Edgecombe, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

64205 Issued in CA

Practice address

11750 Cholla Dr
Desert Hot Springs, CA 92240-3065

Phone

(760) 251-0044

Fax

(858) 634-6948

NPI assigned

Mar 30, 2009

Last updated

Apr 25, 2017By the provider in NPPES

Sex

Male

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aedgecombe305425@direct.llu.edu

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.

• County of Riverside

  • Federally Qualified Health Center (FQHC)
  • Indio, CA
  • NPI 1023122967
  Medicare reassignment NPD
• County of Riverside

  • Federally Qualified Health Center (FQHC)
  • Riverside, CA
  • NPI 1003920943
  NPD
• County of Riverside

  • Clinical Medical Laboratory
  • Riverside, CA
  • NPI 1952496010
  NPD

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1609018118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11750 CHOLLA DR",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922403065",
            "telephone_number": "760-251-0044",
            "fax_number": "858-634-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11750 CHOLLA DR",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922403065",
            "telephone_number": "760-251-0044",
            "fax_number": "858-634-6948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGECOMBE",
        "first_name": "ALPHONSO",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-30",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Dumble
• Ellen Duncan
• Isis B Duran
• Michael Duran
• Sabrina Morgan Eanes
• Howard Joseph Ennaco
• Adolfo Espino, LVN
• Grecy Jennifer Espinoza, PPSC
• Ashley Everett, LVN
• Marko Fam

• Dentist in Desert Hot Springs, CA
• Providers in Desert Hot Springs, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.