Erene Attalla

Primary specialty

DentistTaxonomy code 122300000X

License

DDS101059 Issued in CA

Practice address

36068 Hidden Springs Rd
Ste H
Wildomar, CA 92595-7679

Phone

(951) 579-4065

NPI assigned

Feb 15, 2016

Last updated

Feb 15, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1891154282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 LATIGO LN",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928825898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36068 HIDDEN SPRINGS RD",
            "address_2": "STE H",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957679",
            "telephone_number": "951-579-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTALLA",
        "first_name": "ERENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS101059",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Arroyo, RBT
• Alyssa Artiaga
• Associated Womens Healthcare of the Inland Valley, a Med. Corp
• Nasko Lubenov Atanassov, PT
• Marvin J Atchison, MD
• Tatiana Maria Attobra
• Sarah Aurelio
• Natalie Avalos-Ramirez, RBT
• Susana Avalos
• Bassam Azzam, BS PHARMACY

• Dentist in Wildomar, CA
• Providers in Wildomar, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; 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.