DR PABLO ENRIQUE LICIAGA DDS (NPI# 1295801561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295801561 |
| Entity Type | Organization |
| Organization Name | DR PABLO ENRIQUE LICIAGA DDS |
| Practice Address |
2115 Bacon St San Diego CA 92107 |
| Practice Telephone | 6192242986 |
| Practice Fax Number | 6192242982 |
| Mailing Telephone | 6192242986 |
| Mailing Fax Number | 6192242982 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2015-01-28 |
| Authorized Official Name | DR. PABLO ENRIQUE LICIAGA (DENTIST) |
| Authorized Official Telephone | 6192242986 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 49365 | CA | Dental Providers |
| Street Address |
2115 BACON ST |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033126677 | Pablo Enrique Liciaga | Dentist | 2115 Bacon St, San Diego, CA 92107 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497111322 | Amanda Malicki | Occupational Therapist | 1567 Ocean Front St, San Diego, CA 92107 | 2016-01-07 |
| 1841689031 | Shari Houser | Marriage & Family Therapist | 1969 Sunset Cliffs Blvd, San Diego, CA 92107 | 2015-01-12 |
| 1740627868 | Marie Catherine Dumas | Psychologist | 3863 Coronado Ave, San Diego, CA 92107 | 2013-05-30 |
| 1386914422 | South Bay Internal Medicine and Family Practice | Non-Pharmacy Dispensing Site | 374 H Street, 202, San Diego, CA 92107 | 2012-01-06 |
| 1396023982 | Brooke Michelle Nielsen | Marriage & Family Therapist | 312 S. Cedros Ave. Ste 334, Ste. 304, Solana Beach, CA 92107 | 2011-07-29 |
| 1871890889 | Elizabeth Cantori | Occupational Therapist | 1865 1/2 Ebers St, San Diego, CA 92107 | 2011-02-28 |
| 1861716482 | Dina Chalom | Physical Therapist | 4833 Pescadero Ave Apt 3, San Diego, CA 92107 | 2010-03-25 |
| 1265762983 | David A. Schein | Psychiatry & Neurology | 4517 Newport Avenue, San Diego, CA 92107 | 2009-12-31 |
| 1184836215 | County of San Diego, Aging & Independance Services | Community/Behavioral Health | 4858 Del Mar Ave, San Diego, CA 92107 | 2007-05-03 |
| 1063535813 | James Wilson Jones | Dentist | 1499 Sunset Cliffs Blvd, San Diego, CA 92107 | 2007-04-09 |
| Find all providers in zip 92107 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265048409 | Sara Siraj | Dentist | 7720 Tyrolean Rd, San Diego, CA 92126-1029 | 2020-09-22 |
| 1639785306 | Brittany Jordan Noris | Dentist | 5830 Oberlin Dr Ste 201, San Diego, CA 92121-3754 | 2020-09-18 |
| 1437761475 | Pouya Parsa | Dentist | 12275 Carmel Vista Rd Unit 224, San Diego, CA 92130-2536 | 2020-08-20 |
| 1366060808 | Azadeh Khajavi | Dentist | 16516 Bernardo Center Dr Ste 210, San Diego, CA 92128-2551 | 2020-07-10 |
| 1871127456 | Sandhya Ramanujam | Dentist | 16466 Bernardo Center Dr Ste 185, San Diego, CA 92128-2522 | 2020-02-23 |
| 1396396164 | Khanh Nguyen | Dentist | 8605 Andromeda Rd, San Diego, CA 92126-1803 | 2019-09-24 |
| 1770133977 | Jeffrey Leland Elmer | Dentist | 2310 Craven St Unit 3210, San Diego, CA 92136-5596 | 2019-09-19 |
| 1609429273 | Navya Jampala | Dentist | 10891 Creekbridge Pl, San Diego, CA 92128-5108 | 2019-07-22 |
| 1619529229 | Calli Ann Marando | Dentist | 2310 Craven St # 3230, San Diego, CA 92136-5596 | 2019-07-13 |
| 1669024428 | Bolivia Pereira Hurtado | Dentist | 2303 92136, 2309 Doyle St, San Diego, CA 92136-0001 | 2019-07-11 |
| 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.