Designer Dentistry Group of Rialto

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

48644 Issued in CA

Legal business name

DESIGNER DENTISTRY GROUP OF RIALTO

Practice address

1786 N Riverside Ave
Suite 5
Rialto, CA 92376-8059

Phone

(909) 874-0323

Fax

(909) 874-2984

NPI assigned

Nov 19, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Rafaela Delara

Title

Administrator

Phone

(909) 874-0323

Specialties & licenses 10

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Neela Jeevan Ghatnekar, DDS

  • General Practice Dentistry
  • Rialto, CA
  • NPI 1336285675
  NPD (past)

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290124800000",
    "number": "1710289947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 N RIVERSIDE AVE",
            "address_2": "SUITE 5",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923768059",
            "telephone_number": "909-874-0323",
            "fax_number": "909-874-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1786 N RIVERSIDE AVE",
            "address_2": "SUITE 5",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923768059",
            "telephone_number": "909-874-0323",
            "fax_number": "909-874-2984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESIGNER DENTISTRY GROUP OF RIALTO",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2010-11-19",
        "status": "A",
        "authorized_official_last_name": "DELARA",
        "authorized_official_first_name": "RAFAELA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "909-874-0323",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57581",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57930",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46985",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59318",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58057",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53832",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "38226",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "24358",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "48644",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "25296",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Eduardo Dennis, DPT
• Dental Care of Rialto Inc
• Department of Behavior Health
• Department of Behavioral Health, San Bernardino County Ca (Agewise)
• Department of Behaviour Health, SB County
• Desired Change Therapeutic Solutions a Licensed Clinical Social Worker (Desired Change Therapeutic Solutions)
• Lekha Devasirbatham
• Anthony W. Deza, D.D.S.
• Eunice Ezinne Diabuah
• Diakonia Incorporation

• Orthodontics and Dentofacial Orthopedics Dentistry in Rialto, CA
• Providers in Rialto, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; 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.