Edithann J Graham DMD Ms Inc

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

EDITHANN J GRAHAM DMD MS INC

Practice address

1806 Cable St
San Diego, CA 92107

Phone

(619) 226-4784

Fax

(619) 226-3027

NPI assigned

Aug 4, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Edithann Jennings Graham, DMDNPI 1063490639

Title

Owner/Ceo

Phone

(619) 226-4784

Specialties & licenses 1

Addresses

Other names 1

• Ocean Beach Periodontics and Dental Implants Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edithann Jennings Graham, DMD

  • Periodontics
  • San Diego, CA
  • NPI 1063490639
  NPD Authorized official
• Megan Smith, DMD

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1134642242
  NPD
• Travis Steinberg, DDS

  • Periodontics
  • San Diego, CA
  • NPI 1376083113
  NPD

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628035200000",
    "number": "1255005153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 CABLE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92107",
            "telephone_number": "619-226-4784",
            "fax_number": "619-226-3027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 CABLE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92107",
            "telephone_number": "619-226-4784",
            "fax_number": "619-226-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDITHANN J GRAHAM DMD MS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "EDITHANN",
        "authorized_official_middle_name": "JENNINGS",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "619-226-4784",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ocean Beach Periodontics and Dental Implants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chloe Angelina Edgington
• Muhammad Muzzammil Edhi, MD
• Rina S. Edi, MD
• Shanta Edinburgh, RN, PHN
• Zandra Lorraine Edison
• Edithann J Graham DMD Ms Inc
• Margaret Elizabeth Edlebeck
• Brandon Craig Edmond
• Estrellita Delrosar Edmond, I.D.C
• James Antonio Edmond

• Periodontics in San Diego, CA
• Providers in San Diego, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.