Dentist Providers In Fontana, California

Search Dentist NPI records in Fontana, CA

Search or browse through the NPI records of dentist registered healthcare providers with a business address in Fontana, CA. The listings include accepted insurance information, Medicare acceptance status, and PECOS enrollment data. The total number of NPI records is 198, of which 83 are registered as organizations and 115 as individuals. A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

58% Individuals

42% Organizations

21% Female

37% Male

58% Individual Providers (115)42% Medical Organizations (83)21% Female Providers (42)37% Male Providers (73)

Map of Providers

We have mapped the Dentist providers in Fontana, CA to visually represent the practice location of each individual or organization. Click on any of the the pins to see the provider details at that location.

List of Providers

Table of Dentist NPI Profiles in Fontana, CA
NPI	Name	Address	Insurance	Medicare	PECOS
1003235631	NICK L. LE (Individual)	14976 FOOTHILL BLVD STE 100 FONTANA, CA 92335 (909) 829-5530	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1003588302	SHRIRAJ SHAH DDS, INC (Organization)	16184 FOOTHILL BLVD STE K FONTANA, CA 92335 (909) 770-8916	UnitedHealthcare	Non-Participating Provider	NO
1003964107	ALPESH K PATEL (Individual)	17644 VALLEY BLVD UNIT # 1 FONTANA, CA 92316 (909) 877-0650	Humana	Non-Participating Provider	YES
1033212592	JUGAL K GUPTA (Individual)	11623 CHERRY AVE STE B-2 FONTANA, CA 92337 (909) 355-1485	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1033468368	EDWARD LEE VERA (Individual)	16946 MARYGOLD AVE STE 101 FONTANA, CA 92335 (909) 355-0385	Aetna CVS Health Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO EMI Health Florida Combined Life Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1033761580	SALINA SAFAEI (Individual)	16701 VALLEY BLVD # CD FONTANA, CA 92335 (909) 356-4490	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1033847520	VON WESTERNHAGEN DENTAL CORPORATION CANAM DENTAL (Organization)	9610 SIERRA AVE SUITE 200 FONTANA, CA 92335 (909) 219-8700		Non-Participating Provider	NO
1043443559	GUPTA DENTAL OFFICE (Organization)	16049 BASELINE AVE UNIT 3 FONTANA, CA 92336 (909) 356-9752		Non-Participating Provider	NO
1043488117	ARUN KUMAR GUPTA (Individual)	11623 CHERRY AVE STE B2 FONTANA, CA 92337 (909) 355-1485	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1043993470	SEONGRO YOON DDS INC. (Organization)	7337 EAST AVE. SUITE A FONTANA, CA 92336 (909) 803-2964		Non-Participating Provider	NO
1053411918	JUN SON YOO (Individual)	16920 FOOTHILL BLVD SUITE D FONTANA, CA 92335 (909) 823-3300	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1053556746	MARIA C. GONZALEZ D.D.S., INC (Organization)	16184 FOOTHILL BLVD STE K FONTANA, CA 92335 (909) 770-8916		Non-Participating Provider	NO
1073128039	MAHIN N JAHROMI DENTAL GROUP INC (Organization)	13677 FOOTHILL BLVD BLDG SUITEM FONTANA, CA 92335 (909) 330-2273		Non-Participating Provider	NO
1083753149	MARIA-ISABEL CORREA (Individual)	17171 FOOTHILL BLVD SUITE B FONTANA, CA 92335 (909) 427-0707	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1083847867	CLINICA DENTAL FAMILIAR GUADALUPANA LOURDES CARDOSO DDS INC (Organization)	16701 VALLEY BLVD STE D FONTANA, CA 92335 (909) 356-4490	UnitedHealthcare	Non-Participating Provider	NO
1083958961	MARIA VIRGINIA BRAVO -ESPINOZA DDS, INC HEALTHY SMILE DENTAL PRACTICE (Organization)	16147 FOOTHILL BLVD STE A FONTANA, CA 92335 (909) 251-4721	UnitedHealthcare	Non-Participating Provider	NO
1083963995	CREATIVE SMILES DENTAL (Organization)	17736 SAN BERNARDINO AVE FONTANA, CA 92335 (909) 822-4363		Non-Participating Provider	NO
1093479768	SHRIRAJ SHAH DDS INC (Organization)	16184 FOOTHILL BLVD STE K FONTANA, CA 92335 (909) 770-8916		Non-Participating Provider	NO
1093825168	JULIE MCGHEE (Individual)	8275 SIERRA AVENUE STE 102 FONTANA, CA 92335 (909) 823-7567		Non-Participating Provider	NO
1093831893	KEVIN THANH TRAN (Individual)	8188 SIERRA AVE SUITE H FONTANA, CA 92335 (909) 434-0865		Non-Participating Provider	NO
1093969271	JUN WU DDS INC. GOLDEN COAST DENTAL (Organization)	15034 FOOTHILL BLVD STE A FONTANA, CA 92335 (909) 356-9888		Non-Participating Provider	NO
1104143536	PAUL R. STANLEY DDS INC (Organization)	9781 SIERRA AVE SUITE B FONTANA, CA 92335 (909) 823-4400		Non-Participating Provider	NO
1104955244	LUIS RUBEN CAMBERO (Individual)	8312 JUNIPER AVE FONTANA, CA 92335 (909) 350-2583	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1124182837	AUGUSTO ADRIANO SANTOS (Individual)	10144 SIERRA AVE FONTANA, CA 92335 (909) 428-0565	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1134257140	MILAGROS DE LA ROSA CASTANEDA (Individual)	7337 EAST AVE SUITE A FONTANA, CA 92336 (909) 803-2964	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1144419334	ANWAR ZAKI, NASSER DDS INC (Organization)	8990 SIERRA AVE SUITE #F FONTANA, CA 92335 (909) 371-0022		Non-Participating Provider	NO
1174417935	BOEHM DENTAL SPECIALISTS PC (Organization)	16465 SIERRA LAKES PKWY STE 230 FONTANA, CA 92336 (909) 775-1200		Non-Participating Provider	NO
1184394652	JERIES NADER QOBORSI (Individual)	9193 SIERRA AVE STE D FONTANA, CA 92335 (909) 822-2226	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1184395493	KOHAN AND TSAI PROFESSIONAL DENTAL CORPORATION OF FONTANA (Organization)	9190 SIERRA AVE STE 101 FONTANA, CA 92335 (909) 356-4200		Non-Participating Provider	NO
1194619155	TEERARAT NEAL PHUATRAKOON (Individual)	16120 S HIGHLAND AVE STE 3A FONTANA, CA 92336 (909) 232-8179		Non-Participating Provider	NO
1194922260	SOO-DONG KIM, D.D.S., INC. (Organization)	9261 SIERRA AVE FONTANA, CA 92335 (909) 822-2212		Non-Participating Provider	NO
1194939231	JERRY JOUGLARD (Individual)	9190 SIERRA AVE SUITE 101 FONTANA, CA 92335 (909) 356-4200	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1205051000	LUBCZUK PROFESSIONAL DENTAL CORPORATION FONTANA DENTAL GROUP (Organization)	9193 SIERRA AVE STE D FONTANA, CA 92335 (909) 822-2226		Non-Participating Provider	NO
1215264098	YOUNG KWUN KIM (Individual)	8110 MANGO AVE 101 FONTANA, CA 92335 (909) 829-9324	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1225156664	SUNEETHA SEKHAR GARLAPATI (Individual)	9261 SIERRA AVE FONTANA, CA 92335 (909) 822-2212		Non-Participating Provider	YES
1235994534	MARIAN ESKANDER (Individual)	17025 SIERRA LAKES PKWY FONTANA, CA 92336 (909) 355-3299	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1245087543	JAEWOO CHO DENTAL CORPORATION (Organization)	17736 SAN BERNARDINO AVE FONTANA, CA 92335 (909) 822-4363		Non-Participating Provider	NO
1245371582	RUBEN MENDEZ (Individual)	16701 VALLEY BLVD STE D FONTANA, CA 92335 (909) 356-4490	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1255845947	JESSE SEIFU FELEMA (Individual)	14305 BASELINE AVE FONTANA, CA 92336 (909) 355-1700	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1275151235	NATASHA ROSEMA VEGA-SALAS (Individual)	7993 SIERRA AVE STE D FONTANA, CA 92336 (909) 428-5111	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1275287880	JUN SON Y OO D.D.S INC (Organization)	16920 FOOTHILL BLVD STE D FONTANA, CA 92335 (190) 982-3330		Non-Participating Provider	NO
1275689663	WESTERN DENTAL SERVICES, INC. (Organization)	9765 SIERRA AVE STE A FONTANA, CA 92335 (909) 427-8000		Non-Participating Provider	NO
1275700510	MOHAMAD ABUL-FIELAT (Individual)	9193 SIERRA AVENUE SUITE#B FONTANA, CA 92335 (909) 355-0385	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1275769283	MARITZA DE LA NUEZ (Individual)	16701 VALLEY BLVD STE #D FONTANA, CA 92335 (909) 356-4490		Non-Participating Provider	NO
1285137729	HOA NGUYEN, DMD, INC (Organization)	9190 SIERRA AVE STE 101 FONTANA, CA 92335 (714) 474-1758	UnitedHealthcare	Non-Participating Provider	NO
1285362848	BRITTANY SELF (Individual)	16475 SIERRA LAKES PKWY STE 140 FONTANA, CA 92336 (909) 357-0869	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1285790261	KENT JERROLD FYFE (Individual)	16476 FOOTHILL BLVD FONTANA, CA 92335 (909) 823-0501	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1285878488	GARLAPATI & CHAKKA DENTAL CORPORATION FONTANA SMILES (Organization)	9261 SIERRA AVE FONTANA, CA 92335 (909) 822-2212	UnitedHealthcare	Non-Participating Provider	NO
1285889576	CAMBERO-MUSTAFA DENTAL CORPORATION (Organization)	8312 JUNIPER AVE FONTANA, CA 92335 (909) 350-2583	UnitedHealthcare	Non-Participating Provider	NO
1285927962	MARIO JAVIER CASTELLANOS (Individual)	9725 SIERRA AVE FONTANA, CA 92335 (909) 822-6200	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1295360790	MOHAMMAD ABUL FIELAT DDS INC (Organization)	9193 SIERRA AVE STE #B FONTANA, CA 92335 (909) 320-8704		Non-Participating Provider	NO
1295919587	SIERRA FAMILY DENTAL GROUP INC. (Organization)	9190 SIERRA AVE SUITE 101 FONTANA, CA 92335 (909) 356-4200		Non-Participating Provider	NO
1295956365	CHARLES THOMAS FLOWERS (Individual)	17736 SAN BERNARDINO AVE FONTANA, CA 92335 (909) 822-4363		Non-Participating Provider	NO
1306234976	MATT-PHUOC TRINH, DMD DDS, INC (Organization)	17185 ARROW BLVD FONTANA, CA 92335 (909) 822-4777	UnitedHealthcare	Non-Participating Provider	NO
1316150964	MOHAMMAD ABUL FIELAT DDS INC (Organization)	16946 MARYGOLD AVE STE #101 FONTANA, CA 92335 (909) 355-0385	UnitedHealthcare	Non-Participating Provider	NO
1316469885	OLGA LEIZEROVITZ (Individual)	7426 CHERRY AVE STE 250 FONTANA, CA 92336 (909) 355-9350		Non-Participating Provider	NO
1326357245	DR.BHAGAT UPPAL & SHAH'S MORNINGSIDE DENTAL GROUP MORNINGSIDE DENTAL GROUP (Organization)	14584 BASELINE AVE 340 FONTANA, CA 92336 (909) 822-7374	UnitedHealthcare	Non-Participating Provider	NO
1336211309	MARILOU PANGANIBAN MEDINA (Individual)	14451 FOOTHILL BLVD SUITE 104 FONTANA, CA 92335 (909) 355-6400	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Paramount Paramount Dental	Non-Participating Provider	NO
1346481926	YIPING SONG (Individual)	9193 SIERRA AVE SUITE D FONTANA, CA 92335 (909) 822-2226		Non-Participating Provider	NO
1346936341	MICHAEL MOHAMED ALJABBAN (Individual)	16944 S HIGHLAND AVE STE 400 FONTANA, CA 92336 (909) 746-9960	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1356078083	HICRET ISLAMOGLU (Individual)	16475 SIERRA LAKES PWKY STE 140 FONTANA, CA 92336 (909) 357-0869	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	YES
1356546410	NYASHA MICHELLE SCOTT (Individual)	16465 SIERRA LAKES PKWY STE 255 FONTANA, CA 92336 (909) 350-0770	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1366054348	ETHAR RIYADH AL-WAZEER (Individual)	10144 SIERRA AVE FONTANA, CA 92335 (909) 770-7367	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1376751560	CONSUMERHEALTH, INC. NEWPORT DENTAL - FONTANA (ORTHO) (Organization)	16135 SIERRA LAKES PKWY FONTANA, CA 92336 (909) 356-2006		Non-Participating Provider	NO
1386255461	SHRIRAJ ASHOK SHAH (Individual)	16184 FOOTHILL BLVD STE K FONTANA, CA 92335 (909) 770-8916	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1386819464	SARABJIT MASSOUN (Individual)	16953 SIERRA LAKES PKWY #110 FONTANA, CA 92336 (909) 357-3900	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1396083465	MARCO JAVIER CASTELLANOS (Individual)	9725 SIERRA AVE FONTANA, CA 92335 (909) 822-6200	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1396436887	DANIELA GONZALEZ (Individual)	7950 CHERRY AVE STE 101 FONTANA, CA 92336 (909) 854-5400		Non-Participating Provider	NO
1396474813	BIANCA PATRICIA NINO-LANATHOUA (Individual)	16944 S HIGHLAND AVE STE 400 FONTANA, CA 92336 (909) 275-7179	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1396744629	SUMMIT ORTHODONTICS (Organization)	15258 SUMMIT AVE SUITE 300 FONTANA, CA 92336 (909) 646-9600		Non-Participating Provider	NO
1407051295	HOWARD GENE GLASSMAN (Individual)	14050 CHERRY AVE SUITE A FONTANA, CA 92337 (909) 822-9090	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1407090814	JONATHAN KIM (Individual)	9190 SIERRA AVE #101 FONTANA, CA 92335 (909) 356-4200	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1407334535	GEORGE LEVY PARKER (Individual)	16475 SIERRA LAKES PKWY STE 140 FONTANA, CA 92336 (909) 357-0869	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1407457856	YIYANG ZOU (Individual)	16163 PLUM ST FONTANA, CA 92336 (408) 528-5129	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1417346727	MOSTAFA KOPERLY (Individual)	17113 ARROW BLVD FONTANA, CA 92335 (832) 436-8277	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Paramount Paramount Dental Renaissance Dental	Opted out of Medicare	YES
1417601105	FRANCINE MARIE ESPINOZA (Individual)	16147 FOOTHILL BLVD STE A FONTANA, CA 92335 (909) 251-4721	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1427140284	COMPEAN AND JEFFERSON DENTAL CORPORATION TRIANGLE DENTAL GROUP AND ORTHODONTICS (Organization)	14305 BASELINE AVE FONTANA, CA 92336 (909) 355-1700		Non-Participating Provider	NO
1427363001	RAVINDER GUPTA (Individual)	16049 BASELINE AVE UNIT 3 FONTANA, CA 92336 (909) 356-9752		Non-Participating Provider	NO
1437232378	CHIRAG P VORA (Individual)	15032 SUMMIT AVE SUITE #410 FONTANA, CA 92336 (909) 899-3940	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1437401098	NYASHA M. SCOTT DDS INC LITTLE HOUSE OF SMILES, CHILDREN'S DENTISTRY (Organization)	16465 SIERRA LAKES PKWY SUITE #255 FONTANA, CA 92336 (909) 350-0770	UnitedHealthcare	Non-Participating Provider	NO
1447705397	MIN YOUNG JO (Individual)	16475 SIERRA LAKES PKWY STE 140 FONTANA, CA 92336 (909) 357-0869	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1467672279	ALEXANDRA R AYOUB (Individual)	8110 MANGO AVE SUITE 101 FONTANA, CA 92335 (909) 829-9324	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1477181410	CASTELLANOS DDS INC (Organization)	9725 SIERRA AVE FONTANA, CA 92335 (909) 822-6200		Non-Participating Provider	NO
1477983203	DR STEVE HUANG DMD INC (Organization)	16989 VALLEY BLVD STE B FONTANA, CA 92335 (909) 829-3535		Non-Participating Provider	NO
1487803433	LAURA Y. JIMENEZ, DDS PROF. DENTAL CORP (Organization)	17500 FOOTHILL BLVD FONTANA, CA 92335 (909) 357-7000		Non-Participating Provider	NO
1487953949	MARIA VIRGINIA BRAVO-ESPINOZA (Individual)	16147 FOOTHILL BLVD A FONTANA, CA 92335 (909) 251-4721	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	YES
1497072805	SEJAL SWAPNIL RAJURKAR (Individual)	7798 CHERRY AVE FONTANA, CA 92336 (909) 428-6890	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	YES
1497298970	MARY ROSE COMPEAN (Individual)	14305 BASELINE AVE FONTANA, CA 92336 (909) 355-1700	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1497924997	SOUTHRIDGE DENTAL GROUP (Organization)	14050 CHERRY AVE STE. A FONTANA, CA 92337 (909) 822-9090		Non-Participating Provider	NO
1508011123	ALEXANDRA AYOUB, DDS., A PROFESSIONAL CORPORATION FONTANA DENTAL CARE (Organization)	8110 MANGO AVE SUITE 101 FONTANA, CA 92335 (909) 829-9324		Non-Participating Provider	NO
1508042599	MHD HAZEM MAKHSIDA (Individual)	9765 SIERRA AVE FONTANA, CA 92335 (909) 427-0201	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1508957309	VIVIEN MATIBAG MAGHIRAN (Individual)	14755 FOOTHILL BLVD STE E FONTANA, CA 92335 (909) 349-1360	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1518326214	CONSUMERHEALTH, INC. NEWPORT DENTAL - FONTANA (Organization)	16135 SIERRA LAKES PKWY STE 200 FONTANA, CA 92336 (909) 356-2006		Non-Participating Provider	NO
1518683911	HAN Y KIM DDS, INC (Organization)	16989 VALLEY BLVD STE B FONTANA, CA 92335 (909) 992-8936		Non-Participating Provider	NO
1528194289	FELIZA HELEN BELENO BANEZ (Individual)	9193 SIERRA AVE STE D FONTANA, CA 92335 (909) 822-2226	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	YES
1528260346	S. SIERRA PLAZA DENTISTRY, INC. (Organization)	10660 SOUTH SIERRA AVE. # J FONTANA, CA 92336 (909) 428-0299		Non-Participating Provider	NO
1528831781	SOROURS DENTAL OFFICE CORPORATION (Organization)	17185 ARROW BLVD FONTANA, CA 92335 (909) 587-2474	UnitedHealthcare	Non-Participating Provider	NO
1538264452	NARENDRA G VYAS (Individual)	9647 SIERRA AVENUE FONTANA, CA 92335 (909) 823-5959	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Paramount Paramount Dental	Non-Participating Provider	NO
1538427182	KRUPAL CHHOTU (Individual)	9647 SIERRA AVE FONTANA, CA 92335 (909) 823-5959	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana	Non-Participating Provider	NO
1548209513	FRANK ANTHONY FINAZZO (Individual)	17113 ARROW BLVD FONTANA, CA 92335 (909) 822-3003		Non-Participating Provider	YES
1548385685	YU-CHI RICKY CHUNG (Individual)	17122 SLOVER AVE STE 103 FONTANA, CA 92337 (909) 829-3994	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1548478886	OGANES KARAPETIAN (Individual)	14050 CHERRY AVE STE A FONTANA, CA 92337 (909) 822-9090	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	YES
1558084186	PHILIP THUC BUI (Individual)	9610 SIERRA AVE, FONTANA, CA 92335 FONTANA, CA 92335 (909) 219-8700	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1568633139	MAHIN NOSRATI-JAHROMI (Individual)	13677 FOOTHILL BLVD STE M FONTANA, CA 92335 (909) 330-2273	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Renaissance Dental	Non-Participating Provider	YES
1568974335	JOON MITCHELL HUR (Individual)	16120 S HIGHLAND AVE # 300 FONTANA, CA 92336 (909) 232-8179	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1578255964	NATALIA KIM (Individual)	8485 TAMARIND AVE FONTANA, CA 92335 (909) 356-6852		Non-Participating Provider	NO
1578759866	FRANCISCO JAVIER CORREA (Individual)	17171 FOOTHILL BLVD SUITE B FONTANA, CA 92335 (909) 427-0707	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1588022065	MARILYN MAIA NGUYEN (Individual)	16475 SIERRA LAKES PKWY STE 140 FONTANA, CA 92336 (909) 357-0869	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	YES
1588979744	JOEL CHUL JU KIM (Individual)	8485 TAMARIND AVE STE A FONTANA, CA 92335 (909) 356-6852	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1598044554	MACIEJ SIELSKI (Individual)	16944 S. HIGHLAND AVE STE 400 FONTANA, CA 92336 (909) 275-7179	Aetna CVS Health Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO EMI Health Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1598134769	SIDNEY CHOI (Individual)	7426 CHERRY AVE STE 250 FONTANA, CA 92336 (408) 768-5433	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1598831471	SARMUKH SINGH KANG (Individual)	9870 SIERRA AVE STE B FONTANA, CA 92335 (909) 823-2020		Non-Participating Provider	NO
1598881831	BITA KERENDIAN PARTIYELI (Individual)	9810 SIERRA AVE STE D FONTANA, CA 92335 (909) 429-9090	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1609965888	THOMAS M NGUYEN (Individual)	15258 SUMMIT AVE SUITE 300 FONTANA, CA 92336 (909) 646-9600	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Renaissance Dental	Non-Participating Provider	NO
1619197563	JAMES REX BLALOCK (Individual)	17736 SAN BERNARDINO AVE FONTANA, CA 92335 (909) 822-4363		Non-Participating Provider	NO
1639390107	MARVIN DANILO PEREZ (Individual)	17185 ARROW BLVD FONTANA, CA 92335 (909) 822-4777	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1639476765	FONTANA DENTAL CLINIC (Organization)	16989 VALLEY BLVD SUITE B FONTANA, CA 92335 (909) 829-3535		Non-Participating Provider	NO
1639830243	ESMA ANWAR YACOUB (Individual)	16944 S HIGHLAND AVE STE 400 FONTANA, CA 92336 (909) 275-7179	BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	YES
1639996739	ELBA ALVARADO DDS INC (Organization)	9261 SIERRA AVE FONTANA, CA 92335 (909) 822-2212		Non-Participating Provider	NO
1649041336	OMAR ALFARO (Individual)	16701 VALLEY BLVD STE C FONTANA, CA 92335 (909) 356-4490	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1649414871	CLAUDIA CORTES DDS INC (Organization)	9673 SIERRA AVE SUIT C FONTANA, CA 92335 (909) 452-7883	UnitedHealthcare	Non-Participating Provider	NO
1649667486	FRANK A. FINAZZO, DDS, INC. WINNINGSMILES (Organization)	17113 ARROW BLVD FONTANA, CA 92335 (909) 822-3003		Non-Participating Provider	NO
1649726688	PAUL RICHARD STANLEY (Individual)	9781 SIERRA AVE SUITE B FONTANA, CA 92335 (909) 823-4400		Non-Participating Provider	NO
1649794009	BASSAM W FARGO (Individual)	8275 SIERRA AVE STE 102 FONTANA, CA 92335 (951) 329-7904	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1659315133	MICHAEL ELHAMI KHALIL (Individual)	17113 ARROW BLVD FONTANA, CA 92335 (909) 822-3003	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1659568848	ISABEL CORREA DDS, INC. COMFORT DENTAL CARE (Organization)	17171 FOOTHILL BLVD SUITE B FONTANA, CA 92335 (909) 427-0707		Non-Participating Provider	NO
1669221198	YOUNG-IL JO (Individual)	9610 SIERRA AVE STE 200 FONTANA, CA 92335 (909) 219-8700	Florida Combined Life Humana	Non-Participating Provider	NO
1669294534	OLIVIA OLAZARAN SERRANO (Individual)	9810 SIERRA AVE STE D FONTANA, CA 92335 (909) 417-6070		Non-Participating Provider	NO
1669642963	MARILOU P. MEDINA, DMD, INC. MARYKNOLL DENTAL OFFICE OF MARILOU P. MEDINA, DMD, INC. (Organization)	14451 FOOTHILL BLVD. SUITE 104 FONTANA, CA 92335 (909) 355-6400		Non-Participating Provider	NO
1689097107	GUPTA DENTAL CORPORATION (Organization)	11623 CHERRY AVE SUITE B-2 FONTANA, CA 92337 (909) 355-1485	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Paramount Paramount Dental	Non-Participating Provider	NO
1689097107	GUPTA DENTAL CORPORATION (Organization)	11623 CHERRY AVE SUITE B-2 FONTANA, CA 92337 (909) 355-1485	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Paramount Paramount Dental	Non-Participating Provider	NO
1689351884	MANAVI DENTAL CORPORATION WEST COAST DENTAL & ORTHODONTICS, ADULT & KIDS DENTAL GROUP (Organization)	16120 S HIGHLAND AVE STE 300 FONTANA, CA 92336 (310) 820-9933		Non-Participating Provider	NO
1689718108	SIAMAK AFSHAR (Individual)	11623 CHERRY AVE SUITE B-2 FONTANA, CA 92337 (909) 355-1485	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	YES
1689939167	JASON S. CHING D.D.S., INC. (Organization)	15218 SUMMIT AVE SUITE 150 FONTANA, CA 92336 (909) 333-6875		Non-Participating Provider	NO
1699903609	HELEN H.Y. CHING (Individual)	9810 SIERRA AVE FONTANA, CA 92335 (909) 429-9090	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1700361243	SCHMIDT AND JEFFERSON DENTAL CORPORATION DENTISTS OF FONTANA DENTAL GROUP (Organization)	16944 SOUTH HIGHLAND AVENUE STE. 400 FONTANA, CA 92336 (909) 275-7179		Non-Participating Provider	NO
1700428703	AMIT NAYYAR DDS INC (Organization)	9870 SIERRA AVE STE B FONTANA, CA 92335 (909) 239-0680		Non-Participating Provider	NO
1700901527	PHIL JAE RA (Individual)	11201 SIERRA AVE SUITE 1F FONTANA, CA 92337 (909) 355-3299	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana	Non-Participating Provider	NO
1700911922	KUNJAL PATEL DENTAL CORP HERITAGE DENTAL GROUP (Organization)	13677 FOOTHILL BLVD SUITE #L FONTANA, CA 92335 (909) 899-8040		Non-Participating Provider	NO
1710464060	HYUNG-JU JOHN KIM DDS INC CHILDREN DENTAL WORLD (Organization)	8485 TAMARIND AVE FONTANA, CA 92335 (909) 356-6852		Non-Participating Provider	NO
1710480058	KASHYAP SHARMA (Individual)	17113 ARROW BLVD FONTANA, CA 92335 (909) 822-3003	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental	Non-Participating Provider	NO
1710675285	ANDRO EHAB AZER REFAAT (Individual)	16475 SIERRA LAKES PKWY STE 140 FONTANA, CA 92336 (909) 525-0333	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1710733795	JAEWOO CHO DENTAL CORPORATION THE ART OF SMILES (Organization)	17736 SAN BERNARDINO AVE FONTANA, CA 92335 (909) 822-4363		Non-Participating Provider	NO
1720264815	MARIO J CATELLANOS D.D.S. PC (Organization)	9725 SIERRA AVE FONTANA, CA 92335 (909) 822-6200		Non-Participating Provider	NO
1730468695	STEPHANIE T CALVILLO (Individual)	9922 SIERRA AVE FONTANA, CA 92335 (909) 822-4800	Humana	Non-Participating Provider	YES
1730974007	FONTANA MODERN DENTISTRY, INC (Organization)	10189 CITRUS AVE SUITE 500 FONTANA, CA 92335 (909) 657-2736		Non-Participating Provider	NO
1740664879	SAHAWNEH DENTAL CORPORATION BRIGHT NOW DENTAL - FONTANA (Organization)	16135 SIERRA LAKES PKWY SUITE 200 FONTANA, CA 92336 (909) 356-2006		Non-Participating Provider	NO
1750409181	JUN WU (Individual)	15034 FOOTHILL BLVD STE A FONTANA, CA 92335 (909) 356-9888	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian	Non-Participating Provider	NO
1750419578	SHILPA GUPTA (Individual)	11623 CHERRY AVE SUITE B-2 FONTANA, CA 92337 (909) 355-1485	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1760231989	HOUMAN MIZANI (Individual)	16946 MARYGOLD AVE FONTANA, CA 92335 (909) 355-0385		Non-Participating Provider	NO
1760574867	ANDRZEJ LUBCZUK (Individual)	9193 SIERRA AVE STE D FONTANA, CA 92335 (909) 822-2226	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1760646244	ERICK ELI GUTIERREZ (Individual)	14305 BASELINE AVE FONTANA, CA 92336 (909) 355-1700	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1770717480	DR. VIVIEN M. MAGHIRAN DENTAL CORP (Organization)	14755 FOOTHILL BLVD SUITE E FONTANA, CA 92335 (909) 349-1360	UnitedHealthcare	Non-Participating Provider	NO
1770813214	YANG HEON KIM DDS. INC (Organization)	17736 SAN BERNARDINO AVE FONTANA, CA 92335 (909) 822-4363		Non-Participating Provider	NO
1780089938	TODD EHRLER PROFESSIONAL DENTAL CORPORATION CHILDREN'S DENTAL CENTERS (Organization)	14976 FOOTHILL BLVD SUITE 100 FONTANA, CA 92335 (909) 350-8730		Non-Participating Provider	NO
1790185544	GUPTA DENTAL GROUP, INC. (Organization)	16049 BASELINE AVE UNIT 3 FONTANA, CA 92336 (909) 356-9752	UnitedHealthcare	Non-Participating Provider	NO
1790589133	SATVATABDOL DDS APC (Organization)	14050 CHERRY AVE UNIT A FONTANA, CA 92337 (909) 280-4742		Non-Participating Provider	NO
1801008495	MATT-PHUOC QUY TRINH (Individual)	17480 ARROW BLVD STE 10 FONTANA, CA 92335 (909) 822-4777	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1811004740	HOAN-VU TRUONG (Individual)	15290 SUMMIT AVE SUITE D FONTANA, CA 92336 (909) 899-8811	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1811390578	CALVILLO AND PENALBA DENTAL CORP. GOLDEN WEST DENTISTRY (Organization)	9922 SIERRA AVE FONTANA, CA 92335 (909) 822-4800		Non-Participating Provider	NO
1811462369	JO-ANN DE JESUS AFRICA DDS INC (Organization)	15375 BASELINE AVE STE 5 FONTANA, CA 92336 (909) 904-7778		Non-Participating Provider	NO
1821247826	LAURA YSOLINA JIMENEZ (Individual)	17500 FOOTHILL BLVD STE C2 FONTANA, CA 92335 (909) 357-7000	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1821403353	JANICE KLIM-LEMANN, DDS, APC (Organization)	17113 ARROW BLVD FONTANA, CA 92335 (909) 822-3003		Non-Participating Provider	NO
1831306661	FRATT DENTAL CORPORATION FONTANA DENTAL (Organization)	16135 SIERRA LAKES PKWY FONTANA, CA 92336 (909) 356-2006		Non-Participating Provider	NO
1831403468	ANA VARGAS GODOY (Individual)	14755 FOOTHILL BLVD FONTANA, CA 92335 (909) 349-1360		Non-Participating Provider	NO
1831886357	SARAH LADHANI (Individual)	16475 SIERRA LAKES PKWY STE 140 FONTANA, CA 92336 (205) 585-6160	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1831916980	NORA TAHER SHAMS (Individual)	6644 GOLDEN OAK LN FONTANA, CA 92336 (909) 480-5250		Non-Participating Provider	NO
1841347283	YOGISH MEHTA (Individual)	16075 FOOTHILL BLVD STE J FONTANA, CA 92335 (909) 357-3257	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1841488632	SHAH BHAGAT & UPPAL A PROFESSIONAL DENTAL CORPORTATION SHAH BHAGAT & UPPAL A PROFESSIONAL DENTAL CORPORTION (Organization)	7426 CHERRY AVE STE 250 FONTANA, CA 92336 (909) 355-9350		Non-Participating Provider	NO
1851413975	DR. GUPTA'S & DR. GILL'S DENTAL OFFICE (Organization)	11623 CHERRY AVE STE B-2 FONTANA, CA 92337 (909) 355-1485		Non-Participating Provider	NO
1851512271	TRAN & PHAN, A PROFESSIONAL DENTAL COPORATION SKY FAMILY DENTAL GROUP (Organization)	8188 SIERRA AVE SUITE H FONTANA, CA 92335 (909) 434-0865		Non-Participating Provider	NO
1851546493	VAHAN GRIGORYAN, DDS, INC. (Organization)	7993 SIERRA AVE SUITE D FONTANA, CA 92336 (909) 428-5111	UnitedHealthcare	Non-Participating Provider	NO
1861066706	ABJAR SALIBA DENTAL CORP (Organization)	8990 SIERRA AVE STE F FONTANA, CA 92335 (909) 371-0513		Non-Participating Provider	NO
1861780181	AMIT NAYYAR (Individual)	9870 SIERRA AVE STE B FONTANA, CA 92335 (909) 239-0680	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	NO
1871631358	ELMER B. HILO (Individual)	16981 FOOTHILL BLVD SUITE I FONTANA, CA 92335 (909) 355-2389	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1881994853	XIANG NING HAN D.D.S DENTAL CORPORATION XIANG NING HAN D.D.S. DENTAL CORPORATION (Organization)	17337 ARROW BLVD SUITE 200 FONTANA, CA 92335 (909) 357-1000		Non-Participating Provider	NO
1902003593	JEFFERSON AND CHOKKA DENTAL CORPORATION SIERRA LAKES DENTAL GROUP (Organization)	16475 SIERRA LAKES PARKWAY SUITE 140 FONTANA, CA 92336 (909) 357-0869		Non-Participating Provider	NO
1902185846	RODEF DENTAL CORPORATION (Organization)	9810 SIERRA AVE #D FONTANA, CA 92335 (310) 625-3773		Non-Participating Provider	NO
1902921349	CAMONES DENTAL CORPORATION GOLDEN WEST DENTISTRY (Organization)	9922 SIERRA AVE FONTANA, CA 92335 (909) 822-4800		Non-Participating Provider	NO
1902923642	DIANE PHAN (Individual)	8188 SIERRA AVE SUITE H FONTANA, CA 92335 (909) 434-0865		Non-Participating Provider	NO
1902970783	YANG H KIM (Individual)	17736 SAN BERNARDINO AVE. FONTANA, CA 92335 (909) 822-4363	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	YES
1902995186	HENRY M NGUYEN (Individual)	15258 SUMMIT AVE SUITE 300 FONTANA, CA 92336 (909) 646-9600	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Louisiana Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Blue Cross Blue Shield of Wyoming Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1912611708	JOEL KIM DMD INC (Organization)	8485 TAMARIND AVE FONTANA, CA 92335 (909) 356-6852		Non-Participating Provider	NO
1932398781	BULMARIO MEDINA GONZALEZ (Individual)	7950 CHERRY AVE SUITE 101 FONTANA, CA 92336 (909) 854-5400		Non-Participating Provider	YES
1932430683	CHILDRENS DENTAL CENTERS (Organization)	14976 FOOTHILL BLVD STE 100 FONTANA, CA 92335 (909) 350-8730		Non-Participating Provider	NO
1932487246	WILBERTO ISAAC PENALBA (Individual)	9922 SIERRA AVE FONTANA, CA 92335 (909) 822-4800	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1942356415	THAI QUOC VU (Individual)	10660 SIERRA AVE STE J FONTANA, CA 92337 (909) 428-0299	Humana	Non-Participating Provider	NO
1942432273	JONATHAN BUENJEMIA (Individual)	9193 SIERRA AVE SUITE B FONTANA, CA 92335 (909) 355-0485	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BannerAetna BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Blue Cross Blue Shield of Arizona Cigna Healthcare Delta Dental of Arizona DentaQuest Insurance Company Inc. EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1942782669	ADDISON CHI-KEE CHENG (Individual)	9190 SIERRA AVE STE 101 FONTANA, CA 92335 (909) 356-4200	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1962539403	LAN YANG (Individual)	9193 SIERRA AVE STE D FONTANA, CA 92335 (909) 822-2226	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1962566141	WESTERN DENTAL SERVICES, INC. (Organization)	10144 SIERRA AVE FONTANA, CA 92335 (909) 428-0500		Non-Participating Provider	NO
1982067229	YOUNGKWUN KIM DDS INC (Organization)	8110 MANGO AVE STE 101 FONTANA, CA 92335 (909) 829-9324	UnitedHealthcare	Non-Participating Provider	NO
1982426037	SANDRA HADDAD (Individual)	14305 BASELINE AVE FONTANA, CA 92336 (909) 355-1700		Non-Participating Provider	NO
1992079230	IVAN V. MADZAREVIC (Individual)	8990 SIERRA AVE. #F FONTANA, CA 92335 (909) 823-5039		Non-Participating Provider	NO
1992721302	NEAL VAVRA (Individual)	17122 SLOVER AVE STE 103 FONTANA, CA 92337 (909) 829-3994		Non-Participating Provider	NO
1992908800	JAMAL DENTAL CORPORATION SAHARA DENTAL (Organization)	17250 FOOTHILL BLVD STE E FONTANA, CA 92335 (909) 428-8500		Non-Participating Provider	NO
1992917645	JASON STUART CHING (Individual)	15218 SUMMIT AVE SUITE 150 FONTANA, CA 92336 (909) 333-6875	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental	Non-Participating Provider	NO
1992945893	GUPTA'S DENTAL OFFICE (Organization)	11623 CHERRY AVE STE B2 FONTANA, CA 92337 (909) 355-1485		Non-Participating Provider	NO

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