Active NPI
Lajolla Cosmetic & Family Dentistry Inc
- General Practice Dentistry
- La Jolla, CA
National Provider Identifier
1497946933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 44055
- Legal business name
- LAJOLLA COSMETIC & FAMILY DENTISTRY INC
- Practice address
- 470 Nautilus St
# 212
La Jolla, CA 92037 - Phone
- (858) 459-5591
- Fax
- (858) 459-4242
- NPI assigned
- Aug 8, 2007
- Organization subpart
- Yes
- Parent organization
- LAJOLLA COSMETIC & FAMILY DENTISTRY INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nick Pavlov, DDS
- Title
- Dentist
- Phone
- (858) 459-5591
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 44055 | CA | Primary |
| Dental Clinic/Center | 261QD0000X | 44055 | CA |
Addresses
Primary practice location
470 Nautilus St
# 212
La Jolla, CA 92037
Mailing address
470 Nautilus St
# 212
La Jolla, CA 92037
Phone (858) 459-5591
National Provider Directory
National Provider Directory- Part of
- Lajolla Cosmetic Family Dentistry Inc
Locations
470 Nautilus St
Ste 212
La Jolla, CA 92037
Phone (858) 459-5591
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Vista, CA
- NPI 1154355741
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186531200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1211932800000",
"number": "1497946933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "470 NAUTILUS ST",
"address_2": "# 212",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "92037",
"telephone_number": "858-459-5591",
"fax_number": "858-459-4242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "470 NAUTILUS ST",
"address_2": "# 212",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "92037",
"telephone_number": "858-459-5591",
"fax_number": "858-459-4242"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAJOLLA COSMETIC & FAMILY DENTISTRY INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LAJOLLA COSMETIC & FAMILY DENTISTRY INC",
"enumeration_date": "2007-08-08",
"last_updated": "2008-05-28",
"status": "A",
"authorized_official_last_name": "PAVLOV",
"authorized_official_first_name": "NICK",
"authorized_official_title_or_position": "DENTIST",
"authorized_official_telephone_number": "858-459-5591",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "44055",
"primary": true
},
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": "CA",
"license": "44055",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.