Abraham Nilton Deza Rolando

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

101117 Issued in CA

Practice address

24561 Alessandro Blvd
Moreno Valley, CA 92553-3918

Phone

(951) 242-9857

NPI assigned

Jan 9, 2017

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

• N Ozder Dental Practice Inc

  • Dental Clinic/Center
  • Lakewood, CA
  • NPI 1225510126
  NPD (past)
• West Coast Dental

  • Dental Assistant
  • Clovis, CA
  • NPI 1801186556
  NPD (past)

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1831635317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24561 ALESSANDRO BLVD",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "92553",
            "telephone_number": "951-242-9857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24561 ALESSANDRO BLVD",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533918",
            "telephone_number": "951-242-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEZA ROLANDO",
        "first_name": "ABRAHAM",
        "middle_name": "NILTON",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-09",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "101117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Developmental Client Care
• Developmental Client Care
• Developmental Client Care
• Shawn Patrick Devitt, DO
• Ruth Dewoskin, PA-C
• Anthony E Deza, DDS
• Rocio D Deza, DDS
• Navpreet Kaur Dhillon, MD
• Ravneet Singh Dhillon, DDS
• Sayali Arunkumar Dhuri, PT DPT

• 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 Jan 9, 2017; 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.