NPIMap

Organization Active NPI

San Diego Dental Sleep Therapy, LLC

  • Durable Medical Equipment & Medical Supplies
  • La Mesa, CA
National Provider Identifier
1811259856
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
31914 Issued in CA
Legal business name
SAN DIEGO DENTAL SLEEP THERAPY, LLC
Practice address
8530 La Mesa Blvd
Suite 204
La Mesa, CA 91942-0966
Phone
(619) 460-0714
Fax
(619) 460-0707
NPI assigned
Jun 14, 2012
Last updated
Jun 14, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
RICHARD B. EVANS, D.D.S., INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Authorized official

Name
Dr. Richard B Evans, D.D.S.NPI 1780673202
Title
President
Phone
(619) 460-0714

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 31914 CA Primary
Customized Equipment (DME) 332BC3200X 31914 CA
Prosthetic/Orthotic Supplier 335E00000X 31914 CA

Addresses

Primary practice location

8530 La Mesa Blvd
Suite 204
La Mesa, CA 91942-0966

Mailing address

8530 La Mesa Blvd
Suite 204
La Mesa, CA 91942-0966
Phone (619) 460-0714

Other identifiers 1

IdentifierTypeStateIssuer
31914OtherCADENTIST - STATE LICENSE

National Provider Directory

National Provider Directory
Part of
Richard B Evans DDS Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1339632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339632000000",
    "number": "1811259856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8530 LA MESA BLVD",
            "address_2": "SUITE 204",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919420966",
            "telephone_number": "619-460-0714",
            "fax_number": "619-460-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8530 LA MESA BLVD",
            "address_2": "SUITE 204",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919420966",
            "telephone_number": "619-460-0714",
            "fax_number": "619-460-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO DENTAL SLEEP THERAPY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RICHARD B. EVANS, D.D.S., INC.",
        "enumeration_date": "2012-06-14",
        "last_updated": "2012-06-14",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-460-0714",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "31914",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CA",
            "license": "31914",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": "31914",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST - STATE LICENSE",
            "identifier": "31914",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; 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.