Healthcare Provider Details
I. General information
NPI: 1720477235
Provider Name (Legal Business Name): SKYLER JEFFREY LIATTI DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/21/2015
Last Update Date: 04/19/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
317 N EL CAMINO REAL STE 203
ENCINITAS CA
92024-2813
US
IV. Provider business mailing address
317 N EL CAMINO REAL STE 203
ENCINITAS CA
92024-2813
US
V. Phone/Fax
- Phone: 760-942-4040
- Fax: 760-942-4040
- Phone: 760-942-4040
- Fax: 760-942-4040
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 64172 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | 64172 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: