NPIMap

Organization Active NPI

Mechael Professional Dental Corporation

Doing business as El Cajon Family Dental

  • General Practice Dentistry
  • El Cajon, CA
National Provider Identifier
1356455422
Registry record updated Jul 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
47950 Issued in CA
Legal business name
MECHAEL PROFESSIONAL DENTAL CORPORATION
Doing business as
El Cajon Family Dental
Practice address
2720 Fletcher Parkway
El Cajon, CA 92020
Phone
(619) 466-1292
Fax
(619) 466-1561
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2009

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

Authorized official

Name
Shatha Faraj Mechael, DDSNPI 1174620348
Title
President/Ceo
Phone
(619) 466-1292

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 31040 CA
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 47950 CA Primary

Addresses

Primary practice location

2720 Fletcher Parkway
El Cajon, CA 92020

Mailing address

2720 Fletcher Parkway
El Cajon, CA 92020
Phone (619) 466-1292

Other names 1

  • El Cajon Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

2720 Fletcher Pkwy
El Cajon, CA 92020
Phone (619) 466-1292

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": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248134400000",
    "number": "1356455422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 FLETCHER PARKWAY",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "92020",
            "telephone_number": "619-466-1292",
            "fax_number": "619-466-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 FLETCHER PARKWAY",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "92020",
            "telephone_number": "619-466-1292",
            "fax_number": "619-466-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECHAEL PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2009-07-21",
        "status": "A",
        "authorized_official_last_name": "MECHAEL",
        "authorized_official_first_name": "SHATHA",
        "authorized_official_middle_name": "FARAJ",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "619-466-1292",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31040",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "El Cajon Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; 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.