NPIMap

Organization Active NPI

Branch Dental Clinic Las Pulgas

  • Dental Clinic/Center
  • Camp Pendleton, CA
National Provider Identifier
1730366287
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BRANCH DENTAL CLINIC LAS PULGAS
Practice address
14TH Street
Building 13128
Camp Pendleton, CA 92055
Phone
(760) 725-3213
Fax
(760) 725-8223
NPI assigned
Jan 28, 2008
Organization subpart
Yes
Parent organization
NAVAL HOSPITAL CAMP PENDLETONAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Mr. William Michael Condon
Title
Navy Medicine Ubo Program Manager
Phone
(240) 401-3643

National Provider Directory

National Provider Directory
Tax ID family
Branch Medical Clinic Area 2243 organizations share this tax ID, including this one
Part of
Branch Medical Clinic Area 22

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

NPPES NPI Registry

Primary practice location

14TH Street
Building 13128
Camp Pendleton, CA 92055

Mailing address

PO Box 555221
Camp Pendleton, CA 92055-5221
Phone (760) 725-3213

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 25, 2018.

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527206400000",
    "number": "1730366287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 555221",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555221",
            "telephone_number": "760-725-3213",
            "fax_number": "760-725-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14TH STREET",
            "address_2": "BUILDING 13128",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "760-725-3213",
            "fax_number": "760-725-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH DENTAL CLINIC LAS PULGAS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL HOSPITAL CAMP PENDLETON",
        "enumeration_date": "2008-01-28",
        "last_updated": "2018-05-25",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "NAVY MEDICINE UBO PROGRAM MANAGER",
        "authorized_official_telephone_number": "240-401-3643",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Pendleton, CA

Sources for this page

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