Eldean C Addy, DDS
Individual provider Active NPI General Practice Dentistry · Ventura, CA
NPI 1245310697 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1245310697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 29198 (CA)
- Practice address
- 2617 Loma Vista Rd
Ventura, CA 93003-1548 - Phone
- (805) 643-4704
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 29198 | CA | Yes |
Addresses
Primary practice location
2617 Loma Vista Rd
Ventura, CA 93003-1548
Mailing address
2617 Loma Vista Rd.
Ventura, CA 93003-1548
Other providers in Ventura, CA
- Adam McKillican Chiropractic Inc
- Kristi Adame
- Charles Adams
- Mia Adams
- Donald Steven Addison
- Thomas Adelman
- Melody Mijoy Adesuyan
- Jessica Marie Adkins
- Brad S Adler
- Advanced Quality Home Health Care, Inc.
All providers in Ventura, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.