Healthcare Provider Details

I. General information

NPI: 1144792102
Provider Name (Legal Business Name): BASHAR ALBADRI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2018
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3755 MURPHY CANYON RD STE D
SAN DIEGO CA
92123-4412
US

IV. Provider business mailing address

3755 MURPHY CANYON RD STE D
SAN DIEGO CA
92123-4412
US

V. Phone/Fax

Practice location:
  • Phone: 858-277-2999
  • Fax:
Mailing address:
  • Phone: 858-277-2999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number103453
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: