NPIMap

Organization Active NPI

Granite Hills Dental Team

  • Dentist
  • El Cajon, CA
National Provider Identifier
1902242068
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
52948 Issued in CA
Legal business name
GRANITE HILLS DENTAL TEAM
Practice address
810 Jamacha Rd
Suite #104
El Cajon, CA 92019-6218
Phone
(619) 579-0233
Fax
(619) 579-0691
NPI assigned
May 16, 2013
Last updated
May 16, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Authorized official

Name
Leslie Peariso
Title
Office Manager
Phone
(619) 579-0233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 52948 CA Primary

Addresses

Primary practice location

810 Jamacha Rd
Suite #104
El Cajon, CA 92019-6218

Mailing address

810 Jamacha Rd
Suite #104
El Cajon, CA 92019-6218
Phone (619) 579-0233

National Provider Directory

National Provider Directory

Locations

810 Jamacha Rd
Ste 104
El Cajon, CA 92019
Phone (619) 579-0233

Practitioners & affiliated clinicians

Practitioners 2

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": "1368662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368662400000",
    "number": "1902242068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 JAMACHA RD",
            "address_2": "SUITE #104",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920196218",
            "telephone_number": "619-579-0233",
            "fax_number": "619-579-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 JAMACHA RD",
            "address_2": "SUITE #104",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920196218",
            "telephone_number": "619-579-0233",
            "fax_number": "619-579-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE HILLS DENTAL TEAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-16",
        "last_updated": "2013-05-16",
        "status": "A",
        "authorized_official_last_name": "PEARISO",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "619-579-0233"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "52948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.