Healthcare Provider Details

I. General information

NPI: 1598684847
Provider Name (Legal Business Name): NEDA DRAGISIC DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 MISSION RD # D
SOUTH SAN FRANCISCO CA
94080-1302
US

IV. Provider business mailing address

1131 MISSION RD # D
SOUTH SAN FRANCISCO CA
94080-1302
US

V. Phone/Fax

Practice location:
  • Phone: 650-589-1770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: NEDA DRAGISIC
Title or Position: PRESIDENT
Credential:
Phone: 310-721-7500