FEDOR DENTAL CORPORATION (NPI# 1871071795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871071795 |
| Entity Type | Organization |
| Organization Name | FEDOR DENTAL CORPORATION |
| Other Organization Name | SERRA MESA MODERN DENTISTRY DENTAL GROUP |
| Practice Address |
3268 Greyling Dr San Diego CA 92123 |
| Mailing Address |
17000 Red Hill Ave Irvine CA 92614-5626 |
| Practice Telephone | 8586170620 |
| Mailing Telephone | 7148458890 |
| Mailing Fax Number | 3039520892 |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2018-08-02 |
| Authorized Official Name | GRACE C FEDOR (OWNER) |
| Authorized Official Telephone | 8586170620 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Serra Mesa Modern Dentistry Dental Group | Doing Business As Name - Organization |
| Street Address |
3268 GREYLING DR |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396358214 | Kelsey Mccurdy Murphy | Dentist | 3268 Greyling Dr, San Diego, CA 92123-2230 | 2020-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
| Find all providers in zip 92123 | ||||
| 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.