Individual provider Active NPI

Travis Steinberg, DDS

  • Periodontics
  • San Diego, CA
National Provider Identifier
1376083113
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
103628 Issued in CA
Practice address
1806 Cable St
San Diego, CA 92107-3103
Phone
(619) 226-4784
NPI assigned
Feb 27, 2017
Last updated
May 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 103628 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1806 Cable St
San Diego, CA 92107-3103

Mailing address

3525 Del Mar Heights Rd Ste 743
San Diego, CA 92130-2199
Phone (858) 442-9504

Other practice location 1

3525 Del Mar Heights Rd Ste 743
San Diego, CA 92130-2199
Phone (858) 442-9504

Other practice location 2

266 Avocado Ave Ste A
El Cajon, CA 92020-4670
Phone (619) 440-2152

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
103628CAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Edithann J Graham DMD Ms Inc Periodontics CurrentSince Aug 8, 2021 Accepting new patients
Edithann J Graham DMD Ms Inc CurrentSince May 16, 2021 Accepting new patients
Travis Steinberg DDS Inc. Current Accepting new patients
Dr Edithann Graham PC PastSince Dec 23, 2020 Accepting new patients

Locations

1806 Cable St
San Diego, CA 92107
Phone (619) 226-4784

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1376083113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 DEL MAR HEIGHTS RD STE 743",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302199",
            "telephone_number": "858-442-9504"
        },
        {
            "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": "921073103",
            "telephone_number": "619-226-4784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3525 Del Mar Heights Rd Ste 743",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921302199",
            "country_code": "US",
            "telephone_number": "858-442-9504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "266 Avocado Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "El Cajon",
            "state": "CA",
            "postal_code": "920204670",
            "country_code": "US",
            "telephone_number": "619-440-2152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEINBERG",
        "first_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-27",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "103628",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 May 11, 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.