NPIMap

Organization Active NPI

Pratima S. Gowdar, DDS, Inc

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1275924995
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PRATIMA S. GOWDAR, DDS, INC
Practice address
4655 Cass St. Ste 104,
San Diego, CA 92109
Phone
(858) 483-3302
NPI assigned
Feb 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

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

Authorized official

Name
Dr. Pratima S Gowdar, DDSNPI 1568634020
Title
Dentist/President
Phone
(585) 483-3302

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

4655 Cass St. Ste 104,
San Diego, CA 92109

Mailing address

4655 Cass St. Ste 104,
San Diego, CA 92109
Phone (858) 483-3302

Other names 1

  • Smile Ocean Dental Practice Doing business as

National Provider Directory

National Provider Directory

Locations

4655 Cass St
Ste 104
San Diego, CA 92109
Phone (858) 483-3302

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424131200000",
    "number": "1275924995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 CASS ST. STE 104,",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92109",
            "telephone_number": "858-483-3302",
            "fax_number": "858-483-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 CASS ST. STE 104,",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92109",
            "telephone_number": "858-483-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRATIMA S. GOWDAR, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-17",
        "last_updated": "2015-02-17",
        "status": "A",
        "authorized_official_last_name": "GOWDAR",
        "authorized_official_first_name": "PRATIMA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "585-483-3302",
        "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": "Smile Ocean Dental Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 17, 2015; 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.