NPIMap

Organization Active NPI

Branch Dental Clinic Sub Base San Diego

  • Dental Clinic/Center
  • San Diego, CA
National Provider Identifier
1194903021
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BRANCH DENTAL CLINIC SUB BASE SAN DIEGO
Practice address
140 Sylvester Rd
San Diego, CA 92106-3521
Phone
(619) 556-8200
NPI assigned
Feb 1, 2008
Last updated
Apr 4, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
NAVAL MEDICAL CENTER SAN DIEGOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Authorized official

Name
Mr. William Michael Condon
Title
Navy Medicine Ubo Program Manager
Phone
(240) 401-3643

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

140 Sylvester Rd
San Diego, CA 92106-3521

Mailing address

140 Sylvester Rd
San Diego, CA 92106-3521

National Provider Directory

National Provider Directory
Tax ID family
Naval Medical Center San Diego26 organizations share this tax ID, including this one
Part of
Naval Medical Center San Diego

Other organizations with this tax ID 25

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

View all 25

Locations

140 Sylvester Rd
San Diego, CA 92106
Phone (619) 553-0838

NPI Registry JSON

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1194903021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 SYLVESTER RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921063521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 SYLVESTER RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921063521",
            "telephone_number": "619-556-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH DENTAL CLINIC SUB BASE SAN DIEGO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL MEDICAL CENTER SAN DIEGO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "NAVY MEDICINE UBO PROGRAM MANAGER",
        "authorized_official_telephone_number": "240-401-3643",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "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 4, 2019; 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.