NPIMap

Organization Active NPI

Odenwalder Dental Inc

Doing business as Mission Family Dentistry

  • Dentist
  • Oceanside, CA
National Provider Identifier
1407353873
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS101299 Issued in CA
Legal business name
ODENWALDER DENTAL INC
Doing business as
Mission Family Dentistry
Practice address
3935 Mission Ave Ste 9
Oceanside, CA 92058-7802
Phone
(760) 439-5515
NPI assigned
Apr 11, 2018
Last updated
Apr 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Authorized official

Name
Dr. Sean Kyle Odenwalder, DMDNPI 1538416441
Title
President
Phone
(760) 439-5515

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
Dentist 122300000X DDS101299 CA Primary

Addresses

Primary practice location

3935 Mission Ave Ste 9
Oceanside, CA 92058-7802

Mailing address

3935 Mission Ave Ste 9
Oceanside, CA 92058-7802
Phone (760) 439-5515

Other names 1

  • Mission Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1523404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523404800000",
    "number": "1407353873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3935 MISSION AVE STE 9",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920587802",
            "telephone_number": "760-439-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3935 MISSION AVE STE 9",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920587802",
            "telephone_number": "760-439-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODENWALDER DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-04-11",
        "status": "A",
        "authorized_official_last_name": "ODENWALDER",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-439-5515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS101299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.