NPIMap

Organization Active NPI

Omer M Anisso DDS Inc

Doing business as La Costa Dental Group

  • Dentist
  • Encinitas, CA
National Provider Identifier
1952714149
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
54467 Issued in CA
Legal business name
OMER M ANISSO DDS INC
Doing business as
La Costa Dental Group
Practice address
501 N El Camino Real Ste 200
Encinitas, CA 92024-1335
Phone
(760) 436-2452
NPI assigned
Jun 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Authorized official

Name
Omer Anisso, DDSNPI 1558376046
Title
Owner
Phone
(760) 436-2452

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 54467 CA Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

501 N El Camino Real Ste 200
Encinitas, CA 92024-1335

Mailing address

501 N El Camino Real Ste 200
Encinitas, CA 92024-1335

Other names 1

  • La Costa Dental Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644364800000",
    "number": "1952714149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N EL CAMINO REAL STE 200",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N EL CAMINO REAL STE 200",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241335",
            "telephone_number": "760-436-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMER M ANISSO DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A",
        "authorized_official_last_name": "ANISSO",
        "authorized_official_first_name": "OMER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-436-2452",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "54467",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Costa Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.