Healthcare Provider Details

I. General information

NPI: 1447166269
Provider Name (Legal Business Name): PETER DO DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11645 DUENDA RD
SAN DIEGO CA
92127-1110
US

IV. Provider business mailing address

11645 DUENDA RD
SAN DIEGO CA
92127-1110
US

V. Phone/Fax

Practice location:
  • Phone: 858-487-8177
  • Fax: 858-487-8183
Mailing address:
  • Phone: 858-487-8177
  • Fax: 858-487-8183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. PETER DO
Title or Position: PRESIDENT
Credential: DDS
Phone: 760-216-0433