Individual provider Active NPI

Graham Ashton Harris, DDS

  • Orofacial Pain Dentistry
  • Vista, CA
National Provider Identifier
1912487265
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
License
DDS102908 Issued in CA
Practice address
2095 W Vista Way Ste 218
Vista, CA 92083-6029
Phone
(760) 436-6365
Fax
(760) 436-5123
NPI assigned
Aug 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X DDS104403 CA
Orofacial Pain Dentistry 1223X2210X DDS102908 CA Primary
Oral Medicine Dentistry 125Q00000X DDS102908 CA
Orofacial Pain Dentistry 1223X2210X R862 MN

Addresses

Primary practice location

2095 W Vista Way Ste 218
Vista, CA 92083-6029

Mailing address

2095 W Vista Way Ste 218
Vista, CA 92083-6029
Phone (760) 436-6365

Other practice location 1

11980 San Vicente Blvd Ste 814
Los Angeles, CA 90049-6606
Phone (760) 436-6365

Other practice location 2

5830 Oberlin Dr Ste 202
San Diego, CA 92121-3754
Phone (760) 436-6365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260114002709 CA Practitioner - DentistPractitioner - Orofacial Pain 9133605678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DentistAlso: Orofacial Pain
Education
Univ of Calif, San Francisco School of Dentistry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bradley a Eli Dental CorporationGroup PAC ID 1557682804, 5 clinicians

Practice addresses (Care Compare)

2095 W Vista Way
Suite 218
Vista, CA 92083-6029
Phone (760) 436-6365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS102908CAMDOrofacial Pain Dentist
R862MNMDOrofacial Pain Dentist
DDS104403CAMDCustomized Equipment (DME)
102908CAMDParenteral & Enteral Nutrition Supplies (DME)

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Treatment Partners CurrentSince Dec 11, 2025 Accepting new patients
Bradley a. Eli Dental Corporation Dentist CurrentSince Dec 11, 2025 Accepting new patients

Locations

4403 Manchester Ave
Ste 101
Encinitas, CA 92024
Phone (760) 436-6365

11980 San Vicente Blvd
Ste 814
Los Angeles, CA 90049
Phone (760) 436-6365

5830 Oberlin Dr
Ste 202
San Diego, CA 92121
Phone (760) 436-6365

2095 W Vista Way
Ste 218
Vista, CA 92083
Phone (760) 630-3562

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1912487265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2095 W VISTA WAY STE 218",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836029",
            "telephone_number": "760-436-6365",
            "fax_number": "760-436-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 W VISTA WAY STE 218",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836029",
            "telephone_number": "760-436-6365",
            "fax_number": "760-436-5123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11980 San Vicente Blvd Ste 814",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900496606",
            "country_code": "US",
            "telephone_number": "760-436-6365",
            "fax_number": "760-436-5123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5830 Oberlin Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921213754",
            "country_code": "US",
            "telephone_number": "760-436-6365",
            "fax_number": "760-436-5123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "GRAHAM",
        "middle_name": "ASHTON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-16",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CA",
            "license": "DDS104403",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "CA",
            "license": "DDS102908",
            "primary": true
        },
        {
            "code": "125Q00000X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral Medicine",
            "state": "CA",
            "license": "DDS102908",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "MN",
            "license": "R862",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.