DR. GRACE CATHERINE FEDOR (NPI# 1174076004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174076004 |
| Entity Type | Individual |
| Full Name | DR. GRACE CATHERINE FEDOR |
| Other Name | GRACE LIU |
| Credential | D.D.S. |
| Practice Address |
5638 Mission Center Rd Ste 107 San Diego CA 92108-4348 |
| Mailing Address |
11253 Miro Cir San Diego CA 92131-3313 |
| Practice Telephone | 6192200159 |
| Mailing Telephone | 6612034417 |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2016-07-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
1000550 | CA | Dental Providers |
| Street Address |
5638 MISSION CENTER RD STE 107 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92108-4348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437225091 | Stuart Tani | Dentist | 5638 Mission Center Rd, #104, San Diego, CA 92108-4348 | 2006-11-27 |
| 1689002289 | Rina Patel | Dentist | 5638 Mission Center Rd, Suite 107, San Diego, CA 92108-4348 | 2013-10-17 |
| 1366701096 | Lance Rygg Professional Dental Corporation | Dentist | 5638 Mission Center Rd, Suite 107, San Diego, CA 92108-4348 | 2012-05-15 |
| 1043588346 | Imperial Valley Optometric Corporation | Optometrist | 5638 Mission Center Rd, Ste 103, San Diego, CA 92108-4348 | 2011-12-01 |
| 1023216751 | San Diego Specialty Care | Dentist | 5638 Mission Center Rd, #105, San Diego, CA 92108-4348 | 2007-07-03 |
| 1336366616 | S. T. Tani, A Dental Corporation | Dentist | 5638 Mission Center Rd, #104, San Diego, CA 92108-4348 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902801 | Keri Castaneda | Behavior Technician | 025 Camino Del Rio South Suite 101, San Diego, CA 92108 | 2020-11-06 |
| 1457963738 | Diyana Giorgees | Case Manager/Care Coordinator | 5005 Texas Street, St. 203, San Diego, CA 92108 | 2020-08-19 |
| 1780211896 | Lori Mildred Jerman | Marriage & Family Therapist | Healthy Minds Counseling Services, 1455 Frazee Road, Suite 880, San Diego, CA 92108 | 2020-03-26 |
| 1285260737 | Demetrius Anderson | Counselor | Telecare Corporation Ihot, 1660 Hotel Circle North, Suite 101, San Deigo, CA 92108 | 2020-03-17 |
| 1033742465 | Dasc Medical Inc | Durable Medical Equipment & Medical Supplies | 5520 Gill Village Way, 907, San Diego, CA 92108 | 2020-02-13 |
| 1508401092 | Chanda Denee Kizer | Marriage & Family Therapist | 3517 Camino Del Rio N, Suite 407, San Diego, CA 92108 | 2019-11-08 |
| 1225695562 | Jenna Rose Shurer | Nurse Practitioner | 5030 Camino De La Siesla Ste 106, San Diego, CA 92108 | 2019-05-22 |
| 1952967812 | Martha Kebede Mekonen | Chiropractor | 2667 Camino Del Rio South, Suite #313, San Diego, CA 92108 | 2019-05-16 |
| 1053886135 | Andrea Jiselly Munoz | Behavior Technician | 3505 Camino Del Rio South, Suite 200, San Diego, CA 92108 | 2018-10-04 |
| 1386128916 | Sarah Elisabeth Smith | Counselor | 7575 Metropolitan Dr., San Diego, CA 92108 | 2018-09-19 |
| Find all providers in zip 92108 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455181 | Julia Nguyen | Dentist | 9225 Mira Mesa Blvd Ste 218, San Diego, CA 92126-4811 | 2020-10-22 |
| 1831797489 | Lily Neskin | Dentist | 4454 Shorepointe Way, San Diego, CA 92130-8635 | 2020-10-15 |
| 1487251294 | Zeki Abdulaali | Dentist | 1501 India St Unit 607, San Diego, CA 92101-2449 | 2020-10-05 |
| 1629681895 | Elizabeth Rodriguez | Dentist | 14701 Via Bettona Ste 215, San Diego, CA 92127-4808 | 2020-08-27 |
| 1679183602 | Hayat Fahliogullari-smith | Dentist | 1281 9th Ave Unit 1309, San Diego, CA 92101-4655 | 2020-08-04 |
| 1235768631 | Virgnia Padua Mattson D.m.d. | Dentist | 11717 Bernardo Plaza Ct Ste 100, San Diego, CA 92128-2419 | 2020-04-07 |
| 1154956050 | Enbara Corporation | Dentist | 5189 Clairmont Mesa Blvd, San Diego, CA 92117 | 2020-03-11 |
| 1215568043 | Hage Dental Corporation | Dentist | 3365 Rosecrans St Ste C, San Diego, CA 92110-4256 | 2020-01-30 |
| 1275174310 | Yige Zhao Dental Corporation | Dentist | 9840 Carmel Mountain Rd, San Diego, CA 92129-2812 | 2019-09-30 |
| 1083255111 | Wayne David Gonzales | Dentist | 8031 Linda Vista Rd # 210, San Diego, CA 92111-5110 | 2019-09-30 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.