San Diego Dental Anesthesia

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

Legal business name

SAN DIEGO DENTAL ANESTHESIA

Practice address

1287 Carlsbad Village Drive
Carlsbad, CA 92008

Phone

(619) 339-0760

NPI assigned

Jun 25, 2019

Organization subpart

No

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

Authorized official

Name

Tyler Johnson, DDSNPI 1831334929

Title

President

Phone

(619) 339-0760

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tyler Johnson, DDS

  • Dental Anesthesiology
  • Carlsbad, CA
  • NPI 1831334929
  NPD (past) Authorized official

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561420800000",
    "number": "1710548375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8677 VILLA LA JOLLA DR # 1255",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920372354",
            "telephone_number": "619-339-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1287 CARLSBAD VILLAGE DRIVE",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "92008",
            "telephone_number": "619-339-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO DENTAL ANESTHESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-06-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-339-0760",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jazel Ruivivar Sambo, NP
• Johnathan Sampsell
• Rainier Orville San Agustin
• San Diego Coastal DME, Inc.
• San Diego Compassionate Caregivers
• San Diego Endocrine and Medical Clinic
• San Diego Healthcare Quality Collaborative
• San Diego Medical Electronics, Inc.
• San Diego Mental Health LLC
• San Diego Wellness Dietitian

• Dental Anesthesiology in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Dental Anesthesiology in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.