Mission Valley Dental Arts

Primary specialty

DentistTaxonomy code 122300000X

License

43989 Issued in CA

Legal business name

MISSION VALLEY DENTAL ARTS

Practice address

2333 Camino del Rio S Ste 140
San Diego, CA 92108-3607

Phone

(619) 574-1810

Fax

(619) 574-1326

NPI assigned

Mar 11, 2015

Last updated

Mar 11, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Elmira Khodapanah, DDSNPI 1750595195

Title

Doctor

Phone

(619) 574-1810

Specialties & licenses 1

Addresses

Tax ID family

Elmira Khodapanah DDS Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Elmira Khodapanah DDS Inc

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1003120148
  NPD tax ID

Locations

Practitioners 1

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.

• Elmira Khodapanah, D.D.S

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1750595195
  Authorized official Same address or phone

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

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426032000000",
    "number": "1174916456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 CAMINO DEL RIO S STE 140",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083607",
            "telephone_number": "619-574-1810",
            "fax_number": "619-574-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 CAMINO DEL RIO S STE 140",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083607",
            "telephone_number": "619-574-1810",
            "fax_number": "619-574-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION VALLEY DENTAL ARTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-11",
        "last_updated": "2015-03-11",
        "status": "A",
        "authorized_official_last_name": "KHODAPANAH",
        "authorized_official_first_name": "ELMIRA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "619-574-1810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "43989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mission Pharmacy & Compounding, LTD
• Mission Psychological Services, Inc
• Mission Surgical, Inc.
• Mission Treatment Services, Inc.
• Mission Valley Counseling Associates, Inc (Mission Valley Counseling Associates)
• Mission Valley Family Optometry
• Mission Valley Hegihts Surgery Center
• Mission Valley Medical Infusion Center, PC
• Mission Valley Oral & Maxillofacial Surgery, Inc.
• Mission Valley Psychology, Inc.

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.