=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902080179
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOSEPH R CAVE DDS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/24/2007
-----------------------------------------------------
Last Update Date | 12/24/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4065 3RD AVE STE 300
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92103-2184
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-298-2291
-----------------------------------------------------
Fax | 619-298-8504
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4065 3RD AVE STE 300
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92103-2184
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-298-2291
-----------------------------------------------------
Fax | 619-298-8504
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JOSEPH R CAVE
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 619-298-2291
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223E0200X
-----------------------------------------------------
Taxonomy Name | Endodontics
-----------------------------------------------------
License Number | 29139
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------