MEDICARE: DR. IVAN DELANO REES D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223D0004X	Dental Anesthesiology	GA1658	CA
2	122300000X	Dentist	62360	CA

General Provider Information

NPI Number	:	1679874341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IVAN DELANO REES D.D.S.

Provider Business Mailing Address
First Line	:	25612 BARTON RD
Second Line	:	#168
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-3110
Country	:	US
Telephone Number	:	951-522-4090
Fax Number	:

Provider Business Practice Location Address
First Line	:	744 E CHAPMAN AVE
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92866-1621
Country	:	US
Telephone Number	:	714-538-5582
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2010
Last Update Date	:	12/09/2025

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