Healthcare Provider Details

I. General information

NPI: 1992615116
Provider Name (Legal Business Name): DIMAPILIS DENTAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3760 CONVOY ST STE 330
SAN DIEGO CA
92111-3745
US

IV. Provider business mailing address

3760 CONVOY ST STE 330
SAN DIEGO CA
92111-3745
US

V. Phone/Fax

Practice location:
  • Phone: 619-469-4185
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. JUDEMAR DIMAPILIS
Title or Position: OWNER
Credential: DMD
Phone: 619-469-4185