DR. CALVIN TYLER SKINNER (NPI# 1801406731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801406731 |
| Entity Type | Individual |
| Full Name | DR. CALVIN TYLER SKINNER |
| Credential | DDS |
| Practice Address |
34800 Bob Wilson Drive Building 2, Ground Floor/quality Management Suite San Diego CA 92134 |
| Mailing Address |
1306 Calle Verona Apt 103 Chula Vista CA 91913-1585 |
| Practice Telephone | 6195328038 |
| Practice Fax Number | 6195329153 |
| Mailing Telephone | 2089870402 |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2020-09-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D11305 | OR | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
34800 BOB WILSON DRIVE BUILDING 2, GROUND FLOOR/QUALITY MANAGEMENT SUITE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730167917 | Charles F Jackson | Audiologist | 34800 Bob Wilson Drive, Naval Medical Center, San Diego, San Diego, CA 92134-5000 | 2006-01-06 |
| 1245714476 | Rebekah Elaine Glennnorris | Social Worker | 34800 Bob Wilson Drive, Bldg 1, Floor 2, Suite 208, San Diego, CA 92134 | 2018-09-24 |
| 1942799440 | Jodi Watson | Midwife | 34800 Bob Wilson Drive, San Diego, CA 92134-5000 | 2018-05-09 |
| 1821585332 | Dejanae Hairston | Military Health Care Provider | 34800 Bob Wilson Drive, San Diego, CA 92134 | 2018-04-19 |
| 1124577911 | Lisa Tang | Student in an Organized Health Care Education/Training Program | 34800 Bob Wilson Drive, Naval Medical Ctr, San Diego, CA 92134-5000 | 2016-09-22 |
| 1891241451 | Sterling Thompson | Dentist | 34800 Bob Wilson Drive, Naval Medical Ctr, San Diego, CA 92134-5000 | 2016-09-01 |
| 1851845242 | Oanh Pham Hutson | Student in an Organized Health Care Education/Training Program | 34800 Bob Wilson Drive, Naval Medical Center San Diego, San Diego, CA 92134-5000 | 2016-08-15 |
| 1033560354 | Andrew James Medenbach | Military Health Care Provider | 34800 Bob Wilson Drive, Naval Med Center, San Diego, CA 92134 | 2016-06-28 |
| 1104277953 | Jaydeep Raval | Military Health Care Provider | 34800 Bob Wilson Drive, Al Medical Center, San Diego, CA 92134-5000 | 2016-06-23 |
| 1770947939 | William Christopher Dyer | Dentist | 34800 Bob Wilson Drive, Naval Medical Center San Diego, San Diego, CA 92134-5000 | 2016-04-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477178457 | Joseph Hunter Sampson | Military Health Care Provider | 34101 Farenholt Ave #14, San Diego, CA 92134 | 2020-06-15 |
| 1508495201 | Benjamin Michael Taylor | Military Health Care Provider | Naval Medical Center San Diego Psychiatry Residency Pgm, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2020-04-04 |
| 1255870333 | Dosh Page | Physician Assistant | Swmi Farenholt Avenue, Building 14, San Diego, CA 92134 | 2017-02-22 |
| 1417328063 | Noem Clay Gallego | Military Health Care Provider | 34101 Building 14, Farenholt Avenue, San Diego, CA 92134 | 2015-10-08 |
| 1972999183 | Justin Paul Lachney | Military Health Care Provider | 34101 Farenholt Avenue, San Diego, CA 92134 | 2015-04-14 |
| 1174963532 | Ryan Anders Crane | Otolaryngology | Department of Otolaryngology - Nmc San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134 | 2013-07-01 |
| 1447591268 | Amy B. Cornell | Student in an Organized Health Care Education/Training Program | 34800 Bob Wilson Drive, San Diego, Ca, Apo, AA 92134 | 2013-03-04 |
| 1841562956 | Christopher Patrick Androski Jr. | Emergency Medical Technician, Basic | Naval Medical Center San Diego 38400 Bob Wilson Dr, San Diego, CA 92134 | 2012-02-04 |
| 1164717740 | Jason James Weiner | Internal Medicine | Dept of Internal Medicine, Division of Rheumatology, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2011-06-13 |
| 1225320237 | Kimberly Ann Thompson | Student in an Organized Health Care Education/Training Program | Navy Medical Center San Diego Gme Department, 34800 Bob Wilson Dr., San Diego, CA 92134 | 2011-05-09 |
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| 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 |
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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.