Healthcare Provider Details

I. General information

NPI: 1518166313
Provider Name (Legal Business Name): BRADLEY UDELL SAINSBURY DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7879 EL CAJON BLVD
LA MESA CA
91942-0623
US

IV. Provider business mailing address

7879 EL CAJON BLVD
LA MESA CA
91942-0623
US

V. Phone/Fax

Practice location:
  • Phone: 619-466-2774
  • Fax: 619-466-2873
Mailing address:
  • Phone: 619-466-2774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE00011027
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License NumberABOP1654
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number108365
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: