MR. ANDREW CARRILLO (NPI# 1811451461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811451461 |
| Entity Type | Individual |
| Full Name | MR. ANDREW CARRILLO |
| Credential | RDA |
| Practice Address |
1205 Renaissance Pkwy Ste 240 Rialto CA 92376-2418 |
| Practice Telephone | 9092437939 |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-01-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | RDA89721 | CA | Dental Providers |
| Street Address |
1205 RENAISSANCE PKWY STE 240 |
| City | RIALTO |
| State | CA |
| Zip Code | 92376-2418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760712269 | Jerry Hyun Shim | Dentist | 1205 Renaissance Pkwy Ste 240, Rialto, CA 92376-2418 | 2010-01-05 |
| 1831716570 | Maeledah Rubalcava | Dental Assistant | 1205 Renaissance Pkwy Ste 240, Rialto, CA 92376-2418 | 2020-06-29 |
| 1467090514 | Gilbert N/a Pena | Dental Assistant | 1205 Renaissance Pkwy Ste 240, Rialto, CA 92376-2418 | 2019-12-18 |
| 1033755251 | Magdalena Victoria Bianchi | Dental Assistant | 1205 Renaissance Pkwy Ste 240, Rialto, CA 92376-2418 | 2019-11-22 |
| 1144602608 | Erica Wu | Dentist | 1205 Renaissance Pkwy Ste 240, Rialto, CA 92376-2418 | 2015-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780141812 | Sochun Operation, Inc. | Assisted Living Facility | 1441 S. Riverside Ave., Rialto, CA 92376 | 2019-02-25 |
| 1487138244 | National Vision Inc | Technician/Technologist | 1175 Renaissance Parkway, Suite 1050, Rialto, CA 92376 | 2018-09-18 |
| 1942780853 | Pakravan, Manavi & Cohen Dental Corporation | Dentist | 1205 W Renaissance Pkwy, Suite 240, Rialto, CA 92376 | 2018-08-20 |
| 1114430238 | Li Watkins | Nurse Practitioner | 280 N Riverside Avenue, Rialto, CA 92376 | 2017-11-10 |
| 1346767837 | Imelda Jazmin Ceja Nunez | Behavioral Analyst | 462 E Wilson St, Rialto, CA 92376 | 2017-08-24 |
| 1720505662 | Taylor Sandoval | Behavioral Analyst | 2935 Cardamon St, Rialto, CA 92376 | 2017-08-22 |
| 1427572510 | Danielle Mccree | Physical Therapy Assistant | 1470 N Filmore Ave, Rialto, CA 92376 | 2017-07-31 |
| 1639699952 | Albert Anthony Torres | Specialist/Technologist | 1008 N. Pampas Ave., Rialto, CA 92376 | 2017-06-27 |
| 1124407358 | Miesha Warren | Peer Specialist | 850 East Foothill Bld, Rialto, CA 92376 | 2015-05-20 |
| 1205233483 | Albert Archuleta | Counselor | 1501 Riverside Ave, Rialto, CA 92376 | 2014-12-03 |
| Find all providers in zip 92376 | ||||
| Taxonomy Code | 126800000X |
| Grouping | Dental Providers |
| Classification | Dental Assistant |
| An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245864826 | Marifer Hawkins | Dental Assistant | 1205 Renaissance Pkwy, Rialto, CA 92376-2417 | 2020-02-23 |
| 1376002287 | Erica Berenice Licea | Dental Assistant | 1342 W La Gloria Dr, Rialto, CA 92377-4466 | 2019-03-19 |
| 1033681549 | Guillermina Viveros Rosas | Dental Assistant | 1205 Renaissance Pkwy Unit 420, Rialto, CA 92376-2417 | 2018-12-21 |
| 1700371390 | Erica Maria Quinn | Dental Assistant | 1554 N Palm Ave, Rialto, CA 92376-3407 | 2018-06-26 |
| 1982846440 | Erika Lashea Tarver | Dental Assistant | 301 W Winchester Dr, Apt4, Rialto, CA 92376-3354 | 2009-03-30 |
| 1831716570 | Maeledah Rubalcava | Dental Assistant | 1205 Renaissance Pkwy Ste 240, Rialto, CA 92376-2418 | 2020-06-29 |
| 1467090514 | Gilbert N/a Pena | Dental Assistant | 1205 Renaissance Pkwy Ste 240, Rialto, CA 92376-2418 | 2019-12-18 |
| 1033755251 | Magdalena Victoria Bianchi | Dental Assistant | 1205 Renaissance Pkwy Ste 240, Rialto, CA 92376-2418 | 2019-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779499 | Candelaria S Muro | Dental Assistant | 34390 Scotella Rd, Temecula, CA 92592-9352 | 2020-10-29 |
| 1609476647 | Corie Zenobia Rideau | Dental Assistant | 26511 Thoroughbred Ln, Moreno Valley, CA 92555-2965 | 2020-10-28 |
| 1255930921 | Darlene Marie Piltingsrud | Dental Assistant | 13128 14 Th St, Camp Pendelton, CA 92055-5221 | 2020-10-22 |
| 1770182529 | Virginia Santiago Williams | Dental Assistant | 21 Area Dental Clinic, Bldg 210735 C St, Camp Pendleton, CA 92055-5221 | 2020-10-22 |
| 1649878968 | Rosalyn Mendoza | Dental Assistant | 18264 Ramona Ave, Fontana, CA 92336-3060 | 2020-10-09 |
| 1700483062 | Alyssa R Mauro | Dental Assistant | 5681 Raintree Way, Oceanside, CA 92057-4813 | 2020-10-08 |
| 1588261119 | Andrea Conners | Dental Assistant | 13218 Avalon Blvd Apt 219, Los Angeles, CA 90061-2363 | 2020-10-06 |
| 1720695984 | Douglas Thomas Duncan | Dental Assistant | 92055- 14th Strret, Oceanside, CA 92055 | 2020-09-30 |
| 1548877004 | Juliaisa Gisselle Caldero | Dental Assistant | Bldg 13128, Oceanside, CA 92058 | 2020-09-29 |
| 1528675980 | Dora Louise Young | Dental Assistant | 92055 14th Street, Camp Pendleton, CA 92055 | 2020-09-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.