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SAN DIEGO CENTER FOR ORAL AND MAXILLOFACIAL SURGERY NPI 1376803254


NPI Information

NPI: 1376803254
Provider Name: SAN DIEGO CENTER FOR ORAL AND MAXILLOFACIAL SURGERY
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

CLIA Number: 05D2029253

Address:
8008 FROST ST
SUITE 311
SAN DIEGO, CA
ZIP 92123
Phone: (858) 292-5175
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SAN DIEGO CENTER FOR ORAL AND MAXILLOFACIAL SURGERY is an oral and maxillofacial surgery dentist in San Diego, CA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. SAN DIEGO CENTER FOR ORAL AND MAXILLOFACIAL SURGERY NPI is 1376803254. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8008 FROST ST
SUITE 311
SAN DIEGO, CA
ZIP 92123-205
Phone: (858) 292-5175
Fax: (858) 292-9946

The provider's authorized official is Lynn Jane O'keefe .
The authorized official title is Administrator and has the following contact phone number (858) 292-5175.

The CLIA number assigned to this NPI record is 05D2029253 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/24/2012 and was last updated on 5/24/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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