Healthcare Provider Details

I. General information

NPI: 1679874341
Provider Name (Legal Business Name): IVAN DELANO REES D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2010
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 E CHAPMAN AVE
ORANGE CA
92866-1621
US

IV. Provider business mailing address

25612 BARTON RD #168
LOMA LINDA CA
92354-3110
US

V. Phone/Fax

Practice location:
  • Phone: 714-538-5582
  • Fax:
Mailing address:
  • Phone: 951-522-4090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License NumberGA1658
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number62360
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: