Justin Mercer Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

JUSTIN MERCER DENTAL CORPORATION

Doing business as

Promenade Dentists Dental Group

Practice address

2710 Via de la Valle
Suite B250
Del Mar, CA 92014

Phone

(858) 703-1012

Fax

(858) 224-0955

NPI assigned

Jul 3, 2017

Organization subpart

No

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

Authorized official

Name

Justin Mercer, DDS

Title

Owner

Phone

(858) 703-1012

Specialties & licenses 1

Addresses

Other names 1

• Promenade Dentists Dental Group Doing business as

Locations

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1245751924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8500",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 VIA DE LA VALLE",
            "address_2": "SUITE B250",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "92014",
            "telephone_number": "858-703-1012",
            "fax_number": "858-224-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN MERCER DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-03",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A",
        "authorized_official_last_name": "MERCER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-703-1012",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Promenade Dentists Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Del Mar, CA
• Providers in Del Mar, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.