Susan R Real-Raz, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

42402 Issued in CA

Practice address

12725 Perris Blvd
Moreno Valley, CA 92553-4110

Phone

(951) 486-0119

Fax

(951) 486-9143

NPI assigned

Jan 15, 2007

Sex

Female

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

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.

• Susan R. Real-Raz, DMD, Inc.

  • Dentist
  • Moreno Valley, CA
  • NPI 1740596584
  NPD (past) Authorized official

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1679624902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12725 PERRIS BLVD",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534110",
            "telephone_number": "951-486-0119",
            "fax_number": "951-486-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12725 PERRIS BLVD",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534110",
            "telephone_number": "951-486-0119",
            "fax_number": "951-486-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAL-RAZ",
        "first_name": "SUSAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frances Raymond
• Brittany Chante Geraldine Raynor, DO
• Ana Rayo, LMFT
• Maria L Reabroi, PHARM.D.
• David L Reagan, DDS
• Realtime Transportation 4 You LLC
• Marielle Reataza, M.D.
• Julio Rebollar
• Guadalupe Recio Garcia
• Recover Medical Group PC

• General Practice Dentistry in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.