Organization Active NPI

Enbara Corporation

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1154956050
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ENBARA CORPORATION
Practice address
5189 Clairmont Mesa Blvd
San Diego, CA 92117
Phone
(619) 734-2886
Fax
(619) 489-2661
NPI assigned
Mar 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Authorized official

Name
Dr. Juan Pablo Eng, DDS
Title
Director
Phone
(619) 734-2286

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5189 Clairmont Mesa Blvd
San Diego, CA 92117

Mailing address

425 Milagrosa Circle
Chula Vista, CA 91910
Phone (619) 734-2286

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610928000000",
    "number": "1154956050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 MILAGROSA CIRCLE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91910",
            "telephone_number": "619-734-2286",
            "fax_number": "619-489-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5189 CLAIRMONT MESA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92117",
            "telephone_number": "619-734-2886",
            "fax_number": "619-489-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENBARA CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-11",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A",
        "authorized_official_last_name": "ENG",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "PABLO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "619-734-2286",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "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 Jan 18, 2021; 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.