Healthcare Provider Details
I. General information
NPI: 1336225366
Provider Name (Legal Business Name): BLYTHE ARRINGTON PEEL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/31/2006
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16475 SIERRA LAKES PKWY STE 140
FONTANA CA
92336-1259
US
IV. Provider business mailing address
31620 WRIGHTWOOD RD
BONSALL CA
92003-4708
US
V. Phone/Fax
- Phone: 909-357-4887
- Fax:
- Phone: 909-367-4012
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | CA57815 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | 6228663 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: