NPIMap

Organization Active NPI

Children's Dental Health Center of San Diego

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1255453882
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CHILDREN'S DENTAL HEALTH CENTER OF SAN DIEGO
Practice address
1270 24TH St
San Diego, CA 92102-2012
Phone
(619) 234-8131
Fax
(619) 234-0048
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Authorized official

Name
Dr. Mariluci Costa Byrnes, DDSNPI 1861632234
Title
Director of Dental Operations
Phone
(619) 234-8131

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1270 24TH St
San Diego, CA 92102-2012

Mailing address

1270 24TH St
San Diego, CA 92102-2012
Phone (619) 234-8131

Other names 1

  • San Diego Children's Dental Health Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Children's Dental Health Association of San Diego2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1255453882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 24TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022012",
            "telephone_number": "619-234-8131",
            "fax_number": "619-234-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 24TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022012",
            "telephone_number": "619-234-8131",
            "fax_number": "619-234-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S DENTAL HEALTH CENTER OF SAN DIEGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "BYRNES",
        "authorized_official_first_name": "MARILUCI",
        "authorized_official_middle_name": "COSTA",
        "authorized_official_title_or_position": "DIRECTOR OF DENTAL OPERATIONS",
        "authorized_official_telephone_number": "619-234-8131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Diego Children's Dental Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.