Anam Asif Raza, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS110730 Issued in CA

Practice address

29950 Haun Rd Ste 302
Menifee, CA 92586-6527

Phone

(951) 679-1667

NPI assigned

Sep 18, 2024

Sex

Female

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

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": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1932936309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28099 ROSETTA ST",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925844415",
            "telephone_number": "832-570-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29950 HAUN RD STE 302",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925866527",
            "telephone_number": "951-679-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZA",
        "first_name": "ANAM",
        "middle_name": "ASIF",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS110730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rancho Physical Therapy, Inc.
• Yasiena Randolph
• Safeer Nehaal Rasul, DDS
• Evan M Ravely, PTA
• Jennifer Ravely, P.T.A.
• Dylan Reaves
• Redford Menifee Dental Corporation
• Tamia Jade Redmon
• Silvia Reid, NP
• Sally Reiter

• General Practice Dentistry in Menifee, CA
• Providers in Menifee, 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 Sep 18, 2024; 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.