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NPI Code Detail

MEDICARE: DENTAL SPECIALTY ASSOCIATES

MEDICARE: DENTAL SPECIALTY ASSOCIATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry26834CA
21223X0400XOrthodontics and Dentofacial Orthopedics Dentistry32635CA

General Provider Information

NPI Number : 1992795272
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL SPECIALTY ASSOCIATES
Provider Business Mailing Address
First Line : 477 N EL CAMINO REAL
Second Line : B203
City : ENCINITAS
State : CA
Zip : 92024-1328
Country : US
Telephone Number : 760-942-1131
Fax Number : 760-942-1708
Provider Business Practice Location Address
First Line : 477 N EL CAMINO REAL
Second Line : B203
City : ENCINITAS
State : CA
Zip : 92024-1328
Country : US
Telephone Number : 760-942-1131
Fax Number : 760-942-1708
Authorized Official
Title or Position : OWNER
Name : DR. JOHN PATRICK DAVIS
Credential : DDS, MS
Telephone Number : 760-942-1131
Provider Enumeration Date : 10/26/2005
Last Update Date : 09/11/2025

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Directions to “DENTAL SPECIALTY ASSOCIATES ” Practice Location

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