South Bay Pediatric Dental Group

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

SOUTH BAY PEDIATRIC DENTAL GROUP

Practice address

2446 Fenton St
Suite 102
Chula Vista, CA 91914-3516

Phone

(619) 216-1100

Fax

(619) 216-1127

NPI assigned

Sep 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Todd W Pacofsky, DMD

Title

Partner

Phone

(619) 216-1100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190678400000",
    "number": "1467649350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2446 FENTON ST",
            "address_2": "SUITE 102",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143516",
            "telephone_number": "619-216-1100",
            "fax_number": "619-216-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2446 FENTON ST",
            "address_2": "SUITE 102",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143516",
            "telephone_number": "619-216-1100",
            "fax_number": "619-216-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY PEDIATRIC DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2007-09-25",
        "status": "A",
        "authorized_official_last_name": "PACOFSKY",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "619-216-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Bay Hearing & Balance
• South Bay Internal Medical GRP Inc
• South Bay Internal Medicine and Family Practice Group Inc
• South Bay Mediquipment Inc
• South Bay OBGYN
• South Bay Physical Medicine, Inc.
• South Bay Serenity and Guidance
• South Bay Skin & Cancer Medical Group, Inc.
• South Bay Surgical Associates Medical Group Inc.
• Southbay Cardiovascular Medical Center, Inc

• Pediatric Dentistry in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.