Active NPI
Christopher John Eitzen, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- San Diego, CA
National Provider Identifier
1932276607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 46180
- Practice address
- 11616 Iberia Place
San Diego, CA 92128 - Phone
- (858) 676-5000
- Fax
- (858) 676-5016
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 46180 | CA | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 46180 | CA | Primary |
Addresses
Primary practice location
11616 Iberia Place
San Diego, CA 92128
Mailing address
11508 Freshwind Court
San Diego, CA 92127
Phone (858) 676-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 173912 | Other | UNITED CONCORDIA INS ORTH | |
| 809272 | Other | UNITED CONCORDIA INS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46180 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dixon and Thurston | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- San Diego, CA
- NPI 1396812087
Pediatric Dentistry
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1932276607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11508 FRESHWIND COURT",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92127",
"telephone_number": "858-676-5000",
"fax_number": "858-676-5016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11616 IBERIA PLACE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92128",
"telephone_number": "858-676-5000",
"fax_number": "858-676-5016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EITZEN",
"first_name": "CHRISTOPHER",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "46180",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "46180",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA INS ORTH",
"identifier": "173912",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA INS",
"identifier": "809272",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.