SAN DIEGO DENTAL ANESTHESIA (NPI# 1710548375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710548375 |
| Entity Type | Organization |
| Organization Name | SAN DIEGO DENTAL ANESTHESIA |
| Practice Address |
1287 Carlsbad Village Drive Carlsbad CA 92008 |
| Mailing Address |
8677 Villa La Jolla Dr # 1255 La Jolla CA 92037-2354 |
| Practice Telephone | 6193390760 |
| Mailing Telephone | 6193390760 |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-06-25 |
| Authorized Official Name | TYLER JOHNSON (PRESIDENT) |
| Authorized Official Telephone | 6193390760 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223D0004X |
Dentist Specialization: Dentist Anesthesiologist |
Dental Providers |
| Street Address |
1287 CARLSBAD VILLAGE DRIVE |
| City | CARLSBAD |
| State | CA |
| Zip Code | 92008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760029706 | Todd F Ovokaitys | Internal Medicine | 2260 Rutherford Road, Suite 101, C/o Gematria, Carlsbad, CA 92008 | 2019-12-10 |
| 1972096717 | Toshiya Kawano | Chiropractor | 5650 El Camino Real Ste 285, Carlsbad, CA 92008 | 2018-06-06 |
| 1184111684 | Brittany Lauren Cheatham | Nurse Practitioner | 345 Walnut Ave, Carlsbad, CA 92008 | 2018-04-19 |
| 1770092843 | Michele Laporte Downey | Counselor | 2910 Jefferson St, Suite 100, Carsbad, CA 92008 | 2017-09-21 |
| 1225567142 | Shana Smith | Occupational Therapy Assistant | 5870 El Camino Real, Carlsbad, CA 92008 | 2017-06-05 |
| 1336690395 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 2559 Camino Real Rd, Carlsbad, CA 92008 | 2016-10-14 |
| 1093174849 | Nhi Thi Diem Nguyen | Pharmacist | 6850 Avenida Encinas, Carlsbad, CA 92008 | 2016-02-22 |
| 1912362112 | Brooke Ann Bellomio | Psychologist | 2558 Roosevelt St. Suite 203, Carlsbad, CA 92008 | 2015-12-15 |
| 1285005660 | Thanh-trinh Doan | Optometrist | 2322 Rutherford Rd., Carlsbad, CA 92008 | 2015-10-12 |
| 1497179519 | Integrative and Holistic Center for Hormone Balancing, Inc. | Specialist | 2892 Jefferson Street, Carlsbad, CA 92008 | 2014-02-10 |
| Find all providers in zip 92008 | ||||
| Taxonomy Code | 1223D0004X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Dentist Anesthesiologist |
| A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation’s Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. |
| Notes: Source: The American Society of Dentist Anesthesiologists [1/1/2013: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740770650 | Jana Sabo Dds Inc | Dentist | 1196 Valencia St Unit 106, San Francisco, CA 94110-3027 | 2018-05-16 |
| 1124524236 | Kristin Chino | Dentist | 225 4th Ave Apt 204, Venice, CA 90291-8607 | 2018-04-05 |
| 1831644053 | Marco Savittieri | Dentist | 3715 Ruette De Vl, San Diego, CA 92130 | 2016-08-17 |
| 1245680271 | Ryan Cheung | Dentist | 8055 West Manchester Avenue, Suite 204, Playa Del Rey, CA 90293 | 2016-06-21 |
| 1245687706 | Wonil Edward Jung | Dentist | 14320 Ventura Blvd, Ste 223, Sherman Oaks, CA 91423-2717 | 2016-05-15 |
| 1861848152 | Phelon Rammell | Dentist | 24837 Tulip Ave, Loma Linda, CA 92354-3405 | 2016-05-05 |
| 1497115547 | Wolf and Bear Dental Care LLC | Dentist | 3023 Bunker Hill St Ste 105, San Diego, CA 92109-5706 | 2016-03-02 |
| 1871964742 | Rachelle Kim | Dentist | 25246 Barton Rd Apt 8, Loma Linda, CA 92354-3055 | 2015-10-16 |
| 1346651262 | Stephen Cotter | Dentist | 3909 Sierra Linda Dr, Escondido, CA 92025-7653 | 2014-05-13 |
| 1396185369 | George Jaber | Dentist | 4804 Mission St Ste 123, San Francisco, CA 94112-3469 | 2013-07-04 |
| Find all providers with the same taxonomy | ||||
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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.