Healthcare Provider Details

I. General information

NPI: 1780595157
Provider Name (Legal Business Name): TOZZER & BAJWA DENTAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 RIDGEBACK RD STE 24
CHULA VISTA CA
91910-6990
US

IV. Provider business mailing address

50 MONTICELLO
IRVINE CA
92620-2630
US

V. Phone/Fax

Practice location:
  • Phone: 949-857-1270
  • Fax:
Mailing address:
  • Phone: 949-857-1270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: CHARLES P TOZZER
Title or Position: OWNER
Credential: DDS
Phone: 949-857-1270