Healthcare Provider Details

I. General information

NPI: 1043819998
Provider Name (Legal Business Name): ALDABE DMD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2020
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5189 CLAIREMONT MESA BLVD
SAN DIEGO CA
92117-1446
US

IV. Provider business mailing address

5189 CLAIREMONT MESA BLVD
SAN DIEGO CA
92117-1446
US

V. Phone/Fax

Practice location:
  • Phone: 858-277-4764
  • Fax:
Mailing address:
  • Phone: 858-277-4764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. ALI ALDABE
Title or Position: PRESIDENT
Credential: DMD
Phone: 858-277-4764