Organization Active NPI

Douglas M Grosmark DMD Incorporated

  • Dentist
  • San Diego, CA
National Provider Identifier
1043639230
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DOUGLAS M GROSMARK DMD INCORPORATED
Practice address
6398 Del Cerro Blvd Ste 1
San Diego, CA 92120-4760
Phone
(619) 286-1181
Fax
(619) 286-1438
NPI assigned
Apr 15, 2014
Last updated
Apr 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Elaine Lopez
Title
Office Administrator
Phone
(619) 286-1181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X CA Primary

Addresses

Primary practice location

6398 Del Cerro Blvd Ste 1
San Diego, CA 92120-4760

Mailing address

6398 Del Cerro Blvd Ste 1
San Diego, CA 92120-4760
Phone (619) 286-1181

National Provider Directory

National Provider Directory

Locations

6398 Del Cerro Blvd
Ste 1
San Diego, CA 92120
Phone (619) 286-1181

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1043639230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6398 DEL CERRO BLVD STE 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204760",
            "telephone_number": "619-286-1181",
            "fax_number": "619-286-1438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6398 DEL CERRO BLVD STE 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204760",
            "telephone_number": "619-286-1181",
            "fax_number": "619-286-1438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS M GROSMARK DMD INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "619-286-1181"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.