Brendan Eghtedar, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

54528 Issued in CA

Practice address

555020 BLDG, #1377
Camp Pendleton, CA 92055-5020

Phone

(866) 980-8989

NPI assigned

Jun 18, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1235492000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17146",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921777146",
            "telephone_number": "858-336-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555020 BLDG, #1377",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555020",
            "telephone_number": "866-980-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGHTEDAR",
        "first_name": "BRENDAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• E. M. Roberts, O.D.
• Nicholas Paulson Eccles, DDS
• Robert Jackson Edge
• Stephen Edwards, D.O.
• Shaun Eggleston, FNP-C
• Bridget Nicole Elder, MD
• Michael Steven Elliott, SOIDC
• Paul Ricky Ena, IDC
• Andrew Ernst, M.D.
• Mary Katherine Erwin, RDH

• Dentist in Camp Pendleton, CA
• Providers in Camp Pendleton, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; 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.