Individual provider Active NPI

Phelon Rammell, DMD

  • Dental Anesthesiology
  • Loma Linda, CA
National Provider Identifier
1861848152
Registry record updated May 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AnesthesiologyTaxonomy code 1223D0004X
License
30871 Issued in TX
Practice address
24837 Tulip Ave
Loma Linda, CA 92354-3405
Phone
(253) 278-8000
NPI assigned
May 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Anesthesiology 1223D0004X 30871 TX Primary

Addresses

Primary practice location

24837 Tulip Ave
Loma Linda, CA 92354-3405

Mailing address

24837 Tulip Ave
Loma Linda, CA 92354-3405
Phone (253) 278-8000

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
30871TXMDDentist Anesthesiologist

NPI Registry JSON

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462406400000",
    "number": "1861848152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24837 TULIP AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543405",
            "telephone_number": "253-278-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24837 TULIP AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543405",
            "telephone_number": "253-278-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMMELL",
        "first_name": "PHELON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-05",
        "last_updated": "2016-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "TX",
            "license": "30871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; 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.