Leland Reuben Raymond III, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

43488 Issued in CA

Practice address

473 E Alessandro Blvd
Suite a
Riverside, CA 92508-6071

Phone

(951) 789-6886

NPI assigned

Jan 8, 2007

Last updated

Apr 28, 2011By the provider in NPPES

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)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Park and Park Dental Group Partnership

  dba Smile Builder

  • Dental Clinic/Center
  • Riverside, CA
  • NPI 1215535182
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303948800000",
    "number": "1912055088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 W. PENNSYLVANIA AVENUE",
            "address_2": "APT 1206",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92374",
            "telephone_number": "909-798-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "473 E ALESSANDRO BLVD",
            "address_2": "SUITE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925086071",
            "telephone_number": "951-789-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "LELAND",
        "middle_name": "REUBEN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2011-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maurice A Rayford, RAS
• Kymberlin Raygoza Lopez
• Pilar Raygoza
• Cornelius Charles Raymond
• Keith Elton Raymond
• Jeanne Jackson Raynes, PH.D.
• Saydi Yiesell Rayon
• Adnan Syed Raza, M.D.
• Landy Mirabel Razafindrabe
• Cara Razo

• General Practice Dentistry in Riverside, CA
• Providers in Riverside, 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 Apr 28, 2011; 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.