Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Mavern Suprono, DDS

Individual provider Dentist · NPI 1023239944

Mr. Mavern Suprono, DDS is a Dentist in Colton, California. Licensed in California. Registered with an NPI since 2007.

Licensed in
CA
In the registry since
2007
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

1080 E Washington B
Colton, CA 92324
Phone: (909) 783-9099
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 27842 (CA)

Record details

NPI number1023239944
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedMay 1, 2007
Last updated in NPPESJuly 8, 2007
Mailing addressPo Box 903, Loma Linda, CA 92354

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