Individual provider Active NPI

Robert R Aviles

  • Dental Hygienist
  • Fontana, CA
National Provider Identifier
1629707997
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
HAP938 Issued in CA
Practice address
7426 Tyler LN
Fontana, CA 92336-5431
Phone
(909) 518-5010
NPI assigned
Jun 10, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental HygienistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 124Q00000X HAP938 CA Primary
Dental HygienistGroup: 193400000X SINGLE SPECIALTY GROUP 124Q00000X 26819 CA

Addresses

Primary practice location

7426 Tyler LN
Fontana, CA 92336-5431

Mailing address

7426 Tyler LN
Fontana, CA 92336-5431
Phone (909) 518-5010

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
HAP938CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Refined White Smiles Dental Hygiene Practice of Robert Aviles Rdhap Dental Hygienist CurrentSince Mar 19, 2023 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": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1629707997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7426 TYLER LN",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365431",
            "telephone_number": "909-518-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7426 TYLER LN",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365431",
            "telephone_number": "909-518-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILES",
        "first_name": "ROBERT",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-10",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "HAP938",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "26819",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.