BRANCH DENTAL CLINIC TWENTYNINE PALMS (NPI# 1477730927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477730927 |
| Entity Type | Organization |
| Organization Name | BRANCH DENTAL CLINIC TWENTYNINE PALMS |
| Practice Address |
14th Street Building 13128 Camp Pendleton CA 92055 |
| Mailing Address |
Po Box 555221 Camp Pendleton CA 92055-5221 |
| Practice Telephone | 7607253213 |
| Practice Fax Number | 7607258223 |
| Mailing Telephone | 7607253213 |
| Mailing Fax Number | 7607258223 |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2018-05-25 |
| Authorized Official Name | MR. WILLIAM MICHAEL CONDON (NAVY MEDICINE UBO PROGRAM MANAGER) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HOSPITAL CAMP PENDLETON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
14TH STREET BUILDING 13128 |
| City | CAMP PENDLETON |
| State | CA |
| Zip Code | 92055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356440317 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 14th Street, Bldg 13129, Camp Pendleton, CA 92055-5191 | 2006-09-22 |
| 1568876605 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 14th Street, Bldg 13129, Camp Pendleton, CA 92055 | 2014-06-17 |
| 1558670695 | Douglas David Steffy | Dentist | 14th Street, 1st Den Bn, Camp Pendleton, CA 92055 | 2010-10-06 |
| 1558548008 | Branch Dental Clinic Edson Range Annex | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055 | 2008-01-28 |
| 1376720821 | Bdc Barstow | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055-5221 | 2008-01-28 |
| 1912184474 | Branch Dental Clinic Bridgeport | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055-5221 | 2008-01-28 |
| 1821275389 | Branch Dental Clinic Miramar | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055 | 2008-01-28 |
| 1093992554 | Branch Dental Clinic Horno | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055 | 2008-01-28 |
| 1568649010 | Branch Dental Clinic San Onofre | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055 | 2008-01-28 |
| 1235316704 | Branch Dental Clinic Las Flores | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055 | 2008-01-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730755 | Zaccary Griffin | Military Health Care Provider | Building 4101 Stuart Mesa Rd, Camp Pendleton, CA 92055 | 2020-11-02 |
| 1194325597 | Connie Lim Good | Dental Hygienist | 14th Street Bldg 13128, Oceanside, CA 92055 | 2020-10-27 |
| 1386243327 | Leticia Isabel Alcantar | Dental Hygienist | Bldg 520448, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1548869571 | Joshua Watersjackson | Specialist/Technologist | 430406 Las Pulgas, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1235737164 | Tynesha Felice Calimquim | Dental Hygienist | Naval Hospital Camp Pendleton, Dental Department, 200 Mercy Circle, Oceanside, CA 92055 | 2020-10-13 |
| 1801494182 | Luis Alberto Necoechea | Military Health Care Provider | 1st Recon Bn Bas, Oceanside, CA 92055 | 2020-10-09 |
| 1689271603 | Lorena Santodomingo | Dental Hygienist | Bldg 210735 C Street, Camp Pendleton, CA 92055 | 2020-10-02 |
| 1720695984 | Douglas Thomas Duncan | Dental Assistant | 92055- 14th Strret, Oceanside, CA 92055 | 2020-09-30 |
| 1528675980 | Dora Louise Young | Dental Assistant | 92055 14th Street, Camp Pendleton, CA 92055 | 2020-09-29 |
| 1306453956 | Lynne Marie Reardon | Dental Hygienist | Bldg 310515, Camp Pendleton, CA 92055 | 2020-09-28 |
| Find all providers in zip 92055 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003093568 | Branch Dental Clinic Margarita | Clinic/Center | 14 Street, Building 13128, Camp Pendleton, CA 92055 | 2008-01-28 |
| 1558548008 | Branch Dental Clinic Edson Range Annex | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055 | 2008-01-28 |
| 1376720821 | Bdc Barstow | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055-5221 | 2008-01-28 |
| 1912184474 | Branch Dental Clinic Bridgeport | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055-5221 | 2008-01-28 |
| 1821275389 | Branch Dental Clinic Miramar | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055 | 2008-01-28 |
| 1093992554 | Branch Dental Clinic Horno | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055 | 2008-01-28 |
| 1568649010 | Branch Dental Clinic San Onofre | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055 | 2008-01-28 |
| 1235316704 | Branch Dental Clinic Las Flores | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055 | 2008-01-28 |
| 1467639914 | Branch Dental Clinic San Meteo | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055 | 2008-01-28 |
| 1730366287 | Branch Dental Clinic Las Pulgas | Clinic/Center | 14th Street, Building 13128, Camp Pendleton, CA 92055 | 2008-01-28 |
| Find all providers in CAMP PENDLETON | ||||
| City | CAMP PENDLETON |
| Zip Code | 92055 |
Please comment or provide details below to improve the information on BRANCH DENTAL CLINIC TWENTYNINE PALMS.
| 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.