Organization Active NPI

Randa Nasr DDS

  • Dentist
  • Chino, CA
National Provider Identifier
1790529287
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
RANDA NASR DDS
Practice address
12854 10TH St Ste D
Chino, CA 91710-4255
Phone
(909) 628-5540
Fax
(909) 627-6533
NPI assigned
Jun 20, 2024
Last updated
Jun 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Authorized official

Name
Dr. Randa Nasr, DDSNPI 1679512453
Title
General Dentist
Phone
(909) 831-2072

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

12854 10TH St Ste D
Chino, CA 91710-4255

Mailing address

12854 10TH St Ste D
Chino, CA 91710-4255
Phone (909) 628-5540

Other names 1

  • Family and Cosmetic Dentistry Former legal business name

National Provider Directory

National Provider Directory

Locations

12854 10th St
Ste D
Chino, CA 91710
Phone (909) 628-5540

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1790529287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12854 10TH ST STE D",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917104255",
            "telephone_number": "909-628-5540",
            "fax_number": "909-627-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12854 10TH ST STE D",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917104255",
            "telephone_number": "909-628-5540",
            "fax_number": "909-627-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDA NASR DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "NASR",
        "authorized_official_first_name": "RANDA",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "909-831-2072",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family and Cosmetic Dentistry",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Chino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.