Individual provider Active NPI

Mirel Wanis, DMD

  • General Practice Dentistry
  • Fontana, CA
National Provider Identifier
1679453625
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS112002 Issued in CA
Practice address
7950 Cherry Ave Ste 105
Fontana, CA 92336-4023
Phone
(626) 224-2783
NPI assigned
Sep 2, 2025
Last updated
Sep 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DDS112002 CA Primary

Addresses

Primary practice location

7950 Cherry Ave Ste 105
Fontana, CA 92336-4023

Mailing address

7950 Cherry Ave Ste 105
Fontana, CA 92336-4023
Phone (626) 224-2783

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
DDS112002CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1756771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1679453625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7950 CHERRY AVE STE 105",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364023",
            "telephone_number": "626-224-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 CHERRY AVE STE 105",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364023",
            "telephone_number": "626-224-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANIS",
        "first_name": "MIREL",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-02",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS112002",
            "primary": true
        }
    ],
    "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 Sep 2, 2025; 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.