Healthcare Provider Details

I. General information

NPI: 1467208686
Provider Name (Legal Business Name): THERESE ABELY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 JACKMAN ST
EL CAJON CA
92020-3053
US

IV. Provider business mailing address

828 JACKMAN ST
EL CAJON CA
92020-3053
US

V. Phone/Fax

Practice location:
  • Phone: 619-768-7869
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDDS112856
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: