Healthcare Provider Details

I. General information

NPI: 1972214757
Provider Name (Legal Business Name): BRADLEY SAINSBURY DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
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: 619-466-2873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRADLEY UDELL SAINSBURY
Title or Position: OWNER/PROVIDER
Credential: DDS
Phone: 619-466-2774