Edward Sall Dental Corporation

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

EDWARD SALL DENTAL CORPORATION

Practice address

5471 Kearny Villa Rd Ste 201
San Diego, CA 92123-1143

Phone

(858) 987-7888

Fax

(619) 299-6222

NPI assigned

Feb 2, 2017

Organization subpart

No

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

Authorized official

Name

Edward Tracy SallNPI 1710961198

Title

President

Phone

(858) 987-7888

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 2

• SleepAlliance, an Edward Sall Dental Practice Doing business as
• Todd Morgan Dental Corporation Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward Tracy Sall, MD,DDS

  • Otolaryngic Allergy Physician
  • Fayetteville, NY
  • NPI 1710961198

  CA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1053859710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5471 KEARNY VILLA RD STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231143",
            "telephone_number": "858-987-7888",
            "fax_number": "619-299-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5471 KEARNY VILLA RD STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231143",
            "telephone_number": "858-987-7888",
            "fax_number": "619-299-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD SALL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-02",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "SALL",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "TRACY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-987-7888"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA SECRETARY OF STATE",
            "identifier": "C3761211",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL BOARD OF CALIFORNIA",
            "identifier": "104553",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SleepAlliance, an Edward Sall Dental Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Todd Morgan Dental Corporation",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Todd Morgan Dental Corporation",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Rachelle Marie Keltner Edstrom, O.D.
• Eduardo Diaz DDS PC
• Pia Alissa Edusada
• Edward Ayub M S a P C
• Edward C Federman M D Inc
• Adam Edwards
• Adina Edwards
• Amber Edwards
• Ayesha J Edwards, LCSW, BCD
• Charles Fessenden Edwards, M.D.

• Customized Equipment (DME) in San Diego, CA
• Providers in San Diego, CA by specialty
• Customized Equipment (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.