DR. AVI WILLIS DMD MAST NPI 1942681069

NPI Information

NPI: 1942681069
Provider Name: DR. AVI WILLIS, DMD, MAST
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

PECOS Registration: Yes

Address:
135 SAXONY RD
ENCINITAS, CA
ZIP 92024
Phone: (760) 634-5437
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DR. Avi Willis, DMD, MAST is a pediatric dentistry dentist in Encinitas, CA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Avi Willis, DMD, MAST NPI is 1942681069. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

135 SAXONY RD
ENCINITAS, CA
ZIP 92024-791
Phone: (760) 634-5437

The NPI 1942681069 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 6/15/2015 and was last updated on 11/9/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0221X	Dentist	Pediatric Dentistry	DS040383	PENNSYLVANIA	No
2	1223P0221X	Dentist	Pediatric Dentistry	22DI02765200	NEW JERSEY	No
3	1223P0221X	Dentist	Pediatric Dentistry	DDS102334	CALIFORNIA	Yes

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

NPI Synchronization or Removal

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