NPIMap

Organization Active NPI

4030 Dental Inc.

  • Dentist
  • San Diego, CA
National Provider Identifier
1275833956
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
4030 DENTAL INC.
Practice address
6175 El Cajon Blvd
San Diego, CA 92115-3915
Phone
(630) 567-6373
NPI assigned
Oct 27, 2010
Last updated
Oct 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Authorized official

Name
Mrs. Rawaa Aldairi
Title
President
Phone
(630) 567-6373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

6175 El Cajon Blvd
San Diego, CA 92115-3915

Mailing address

6175 El Cajon Blvd
San Diego, CA 92115-3915
Phone (619) 583-4030

National Provider Directory

National Provider Directory

Locations

6175 El Cajon Blvd
San Diego, CA 92115
Phone (619) 583-4030

Practitioners & affiliated clinicians

Practitioners 4

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": "1288137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1275833956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6175 EL CAJON BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921153915",
            "telephone_number": "619-583-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6175 EL CAJON BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921153915",
            "telephone_number": "630-567-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4030 DENTAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-27",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "ALDAIRI",
        "authorized_official_first_name": "RAWAA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-567-6373",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 27, 2010; 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.