NPIMap

Organization Active NPI

Del Mar Pediatric & Adolescents Dental Group

  • Dental Clinic/Center
  • San Diego, CA
National Provider Identifier
1972830180
Registry record updated Nov 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
52929 Issued in CA
Legal business name
DEL MAR PEDIATRIC & ADOLESCENTS DENTAL GROUP
Practice address
12750 Carmel Country Rd Ste 215
San Diego, CA 92130-2172
Phone
(858) 259-1400
Fax
(858) 259-1401
NPI assigned
Nov 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2009

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

Authorized official

Name
Soudabeh Sharafi, DMDNPI 1245289107
Title
Dentist
Phone
(858) 259-1400

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 52929 CA Primary

Addresses

Primary practice location

12750 Carmel Country Rd Ste 215
San Diego, CA 92130-2172

Mailing address

12750 Carmel Country Rd Ste 215
San Diego, CA 92130-2172
Phone (858) 259-1400

National Provider Directory

National Provider Directory
Tax ID family
Del Mar Pediatric Adolescents Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12750 Carmel Country Rd
Ste 215
San Diego, CA 92130
Phone (858) 259-1400

Practitioners & affiliated clinicians

Practitioners 2

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": "1257724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257724800000",
    "number": "1972830180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12750 CARMEL COUNTRY RD STE 215",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302172",
            "telephone_number": "858-259-1400",
            "fax_number": "858-259-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12750 CARMEL COUNTRY RD STE 215",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302172",
            "telephone_number": "858-259-1400",
            "fax_number": "858-259-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEL MAR PEDIATRIC & ADOLESCENTS DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-09",
        "last_updated": "2009-11-09",
        "status": "A",
        "authorized_official_last_name": "SHARAFI",
        "authorized_official_first_name": "SOUDABEH",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "858-259-1400",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "52929",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 9, 2009; 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.