Active NPI
Neil Grant Penaflorida, DDS
- Dentist
- Riverside, CA
National Provider Identifier
1992137533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 58441
- Practice address
- 2878 Campus Pkwy
Riverside, CA 92507-0966 - Phone
- (951) 571-0011
- Fax
- (951) 571-0012
- NPI assigned
- Aug 6, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 58441 | CA | Primary |
Addresses
Primary practice location
2878 Campus Pkwy
Riverside, CA 92507-0966
Mailing address
29560 Rancho California Rd
Temecula, CA 92591-5294
Phone (951) 699-2144
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150813011567 | CA | Order and Referring Only - Dentist | 9931414331 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58441 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578268800000",
"number": "1992137533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29560 RANCHO CALIFORNIA RD",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925915294",
"telephone_number": "951-699-2144",
"fax_number": "951-506-4040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2878 CAMPUS PKWY",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925070966",
"telephone_number": "951-571-0011",
"fax_number": "951-571-0012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENAFLORIDA",
"first_name": "NEIL",
"middle_name": "GRANT",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-06",
"last_updated": "2020-01-06",
"certification_date": "2020-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "58441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.