Individual provider Active NPI

Bradley A Eli, DMD, MS

  • Orofacial Pain Dentistry
  • Vista, CA
National Provider Identifier
1205948270
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
License
DS36308 Issued in CA
Practice address
2095 W Vista Way Ste 218
Vista, CA 92083-6029
Phone
(760) 436-6365
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orofacial Pain Dentistry 1223X2210X DS36308 CA Primary
Oral Medicine Dentistry 125Q00000X DS36308 CA
Customized Equipment (DME) 332BC3200X 36308 CA

Addresses

Primary practice location

2095 W Vista Way Ste 218
Vista, CA 92083-6029

Mailing address

2095 W Vista Way Ste 218
Vista, CA 92083-6029
Phone (760) 436-6365

Other practice location 1

5830 Oberlin Dr Ste 202
San Diego, CA 92121-3754
Phone (760) 436-6365

Other practice location 2

11980 San Vicente Blvd Ste 814
Los Angeles, CA 90049-6606
Phone (760) 436-6365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090819000640 CA Practitioner - Oral SurgeryPractitioner - Interventional Pain ManagementPractitioner - Other (Physician) 4587718952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bradley a Eli Dental CorporationGroup PAC ID 1557682804, 5 clinicians

Practice addresses (Care Compare)

2095 W Vista Way
Suite 218
Vista, CA 92083-6029
Phone (760) 436-6365

Merit-based Incentive Payment System (MIPS)

Final score
81.29 of 100Reported as individual
Quality
62.58
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DS36308CAMDOral Medicinist

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Treatment Partners Specialist CurrentSince May 17, 2020 Accepting new patients
Palomar Health Past Accepting new patients
Scripps Health Past Accepting new patients
So Cal Dental Partners Past Accepting new patients
Boyd Dental Corporation Past Accepting new patients
Inland Dental Center Highland Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Scripps Health Past Accepting new patients
Tri-City Hospital Past Accepting new patients
Aaa Sleep Treatment Partners PastSince Nov 16, 2011 Accepting new patients

Locations

4403 Manchester Ave
Ste 101
Encinitas, CA 92024
Phone (760) 436-6365

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1205948270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2095 W VISTA WAY STE 218",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836029",
            "telephone_number": "760-436-6365",
            "fax_number": "760-436-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 W VISTA WAY STE 218",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836029",
            "telephone_number": "760-436-6365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5830 Oberlin Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921213754",
            "country_code": "US",
            "telephone_number": "760-436-6365",
            "fax_number": "760-436-5123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11980 San Vicente Blvd Ste 814",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900496606",
            "country_code": "US",
            "telephone_number": "760-436-6365",
            "fax_number": "760-436-5123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELI",
        "first_name": "BRADLEY",
        "middle_name": "A",
        "credential": "DMD, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "CA",
            "license": "DS36308",
            "primary": true
        },
        {
            "code": "125Q00000X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral Medicine",
            "state": "CA",
            "license": "DS36308",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CA",
            "license": "36308",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.