BOTOX FILLERS DERMATOLOGY INC
NPI 1689567125
Clinic/Center in Rancho Cucamonga, CA
About Botox Fillers Dermatology Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BOTOX FILLERS DERMATOLOGY INC (NPI 1689567125) is a healthcare organization registered as a clinic/center in Rancho Cucamonga, California and active in the NPI registry since June 2025. The organization lists David Opai-tetteh, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Botox Fillers Dermatology Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Botox Fillers Dermatology Inc, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Botox Fillers Dermatology Inc's NPI number?
The NPI number for Botox Fillers Dermatology Inc is 1689567125. It was assigned to this organization in the NPPES registry on June 2, 2025.
Where is Botox Fillers Dermatology Inc located?
Botox Fillers Dermatology Inc is located at 10601 Church St Ste 123, Rancho Cucamonga, CA 91730. The listed phone number is (909) 321-8030.
What is Botox Fillers Dermatology Inc's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is Botox Fillers Dermatology Inc enrolled in Medicare?
Yes. Botox Fillers Dermatology Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Botox Fillers Dermatology Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Botox Fillers Dermatology Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Botox Fillers Dermatology Inc was last updated on November 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Botox Fillers Dermatology Inc · NPI 1689567125
Clinic/Center organization in Rancho Cucamonga, California. Organization record, active in the CMS NPPES registry since June 2, 2025.
## Identity
- **NPI:** 1689567125 (Entity type: Organization)
- **Enumerated:** June 2, 2025
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Organization subpart:** No
- **Authorized official:** David Opai-Tetteh, OWNER
## Practice location
- **Address:** 10601 CHURCH ST STE 123, Rancho Cucamonga, CA 91730-6840
- **Phone:** (909) 321-8030
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Dermatology) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 10, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1689567125) · Data from the CMS NPPES public registry.