SD Dell Dental Corporation

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

SD DELL DENTAL CORPORATION

Doing business as

La Dental Braces San Diego

Practice address

6699 Alvarado Rd Ste 2202
San Diego, CA 92120-5293

Phone

(619) 287-8870

NPI assigned

Sep 5, 2023

Last updated

Sep 5, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Wolff

Title

Supervisor

Phone

(619) 287-8870

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• LA DENTAL BRACES SAN DIEGO Doing business as

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1942086079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6699 ALVARADO RD STE 2202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205293",
            "telephone_number": "619-287-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6699 ALVARADO RD STE 2202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205293",
            "telephone_number": "619-287-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SD DELL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-08-31",
        "status": "A",
        "authorized_official_last_name": "WOLFF",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "619-287-8870"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "1760666705",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LA DENTAL BRACES SAN DIEGO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madeline J Scull, NP
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• SD Health and Acupuncture
• SD Health Holdings
• SD Health Partners Inc (1St Meridian Home Health)
• SD Healthcare RX Inc (Childrens Community Pharmacy)

• Orthodontics and Dentofacial Orthopedics Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.