DR. CHARLES CLAYTON PHILLIPS III (NPI# 1912920745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912920745 |
| Entity Type | Individual |
| Full Name | DR. CHARLES CLAYTON PHILLIPS III |
| Other Name | CHARLES PHILLIPS III |
| Credential | D.M.D. |
| Practice Address |
12395 El Camino Real Ste 304 San Diego CA 92130-3085 |
| Mailing Address |
12395 El Camino Real Ste 304 San Diego CA 92130-3085 |
| Practice Telephone | 8587933393 |
| Practice Fax Number | 8587933383 |
| Mailing Telephone | 8587933393 |
| Mailing Fax Number | 8587933383 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
30008 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841703147 | Charles Vance Phillips Iv | Massage Therapist | 25 Cherokee Blvd Ste C, Chattanooga, TN 37405-3838 | 2017-11-08 |
| 1598064636 | Charles Phillips | Family Medicine | 6045 Carlisle Ln, 6045 Carlisle Ln, Alpharetta, GA 30022-6281 | 2011-03-15 |
| 1093735011 | Charles W Phillips | Optometrist | 4311 W Wadley Ave, Midland, TX 79707-5457 | 2006-07-20 |
| 1902891872 | Charles M Phillips | Dermatology | 517 Moye Blvd Fl 3, Ecu Physicians Dermatology, Greenville, NC 27834-2849 | 2005-09-15 |
| 1023017548 | Charles Bailey Phillips Jr. | Chiropractor | 4045 Vineville Ave, Macon, GA 31210-5039 | 2005-07-18 |
| 1891791299 | Charles Vincent Phillips | Surgery | 3838 San Dimas St, Ste B-231, Bakersfield, CA 93301-2284 | 2005-06-22 |
| 1538164298 | Charles T Phillips | Physician Assistant | 250 Nash Medical Arts Mall, Suite D, Rocky Mount, NC 27804-1470 | 2005-06-17 |
| 1760872808 | Charles Henry Phillips IIi | Physician Assistant | 915 N Greensboro St, Lexington, NC 27292-2699 | 2015-01-28 |
| 1811312986 | Charles Andrew Phillips | Internal Medicine | 509 Biltmore Ave, Asheville, NC 28801-4601 | 2014-02-26 |
| 1265722953 | Charles Allen Phillips | Pediatrics | 3401 Civic Center Blvd, Divisions of Hematology and Oncology, Philadelphia, PA 19104-4319 | 2011-04-14 |
| Street Address |
12395 EL CAMINO REAL STE 304 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92130-3085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457337313 | Scripps Clinic Medical Group | Clinic/Center | 12395 El Camino Real, Suite 120, San Diego, CA 92130-3082 | 2005-12-21 |
| 1003299892 | Roya Mirkhan,dmd,msd,inc. | Dentist | 12395 El Camino Real, Suite Number 314, San Diego, CA 92130-3082 | 2015-06-30 |
| 1033544408 | Sea Breeze Pediatrics, Apc | Clinic/Center | 12395 El Camino Real, Suite 311, San Diego, CA 92130-3082 | 2013-09-04 |
| 1184922197 | Karen Freeman | Dietitian, Registered | 12395 El Camino Real, Suite 115, San Diego, CA 92130 | 2011-03-01 |
| 1487974101 | San Diego Eye Group, Inc. | Ophthalmology | 12395 El Camino Real, Suite 300, San Diego, CA 92130-3085 | 2010-06-03 |
| 1467778456 | Julia Ann Shrivastava | Family Medicine | 12395 El Camino Real, Suite 120, San Diego, CA 92130-3082 | 2010-04-15 |
| 1568795185 | Markos N Botros | Dentist | 12395 El Camino Real, Suite 101, San Diego, CA 92130-3082 | 2009-09-14 |
| 1417190448 | Jason R. Lupton, M.d., Inc. | Dermatology | 12395 El Camino Real, Suite 207, San Diego, CA 92130-3082 | 2009-04-07 |
| 1649439563 | Christen Marie Benke | Family Medicine | 12395 El Camino Real, Suite 120, San Diego, CA 92130-3083 | 2008-06-05 |
| 1689860108 | Carmel Valley Pediatrics | Pediatrics | 12395 El Camino Real, Suite 315, San Diego, CA 92130-3082 | 2007-09-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629692397 | Tlc Family Therapy | Marriage & Family Therapist | 5965 Village Way. Suite 105 #112, San Diego, CA 92130 | 2020-05-29 |
| 1447746169 | Jack Perlov | Psychiatry & Neurology | 3535 Caminito El Rincon, Unit 268, San Diego, CA 92130 | 2018-07-05 |
| 1326551003 | Theotokos, LLC | Pharmacy | 5550 Carmel Mountain Rd Ste 111, San Diego, CA 92130 | 2017-11-16 |
| 1154879146 | Halie Hommes | Occupational Therapist | 12250 El Camino Real Ste 250, San Diego, CA 92130 | 2016-09-19 |
| 1790232015 | Coastal Skin and Eye Institute, Inc. | Ophthalmology | 5550 Carmel Mountain Road, Suite 206, San Diego, CA 92130 | 2016-09-02 |
| 1720534951 | Nosti and Rygg Dental Corporation | Dentist | 5550 Carmel Mountain Road, Ste 200, San Diego, CA 92130 | 2016-08-28 |
| 1831644053 | Marco Savittieri | Dentist | 3715 Ruette De Vl, San Diego, CA 92130 | 2016-08-17 |
| 1336508621 | Discovery Practice Management, Inc | Psychiatric Residential Treatment Facility | 11455 Camino Real, Ste 360, San Diego, CA 92130 | 2016-02-16 |
| 1427434679 | Coast Pediatrics Carmel Valley | Pediatrics | 5965 Village Drive, Suite 201, San Diego, CA 92130 | 2015-08-10 |
| 1659753762 | T Sidal Dds Md Inc | Dentist | 12395 El Camino Real, Suite 304, Torrey Pines Oral & Maxillofacial Surgery, San Diego, CA 92130 | 2015-06-25 |
| Find all providers in zip 92130 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659753762 | T Sidal Dds Md Inc | Dentist | 12395 El Camino Real, Suite 304, Torrey Pines Oral & Maxillofacial Surgery, San Diego, CA 92130 | 2015-06-25 |
| 1346506201 | Jonathan Joseph Shelton | Dentist | 6386 Alvarado Ct Ste 110, San Diego, CA 92120 | 2012-04-04 |
| 1326350851 | Payam Afzali | Dentist | 11962 Stoney Peak Dr Apt 1222, San Diego, CA 92128-6483 | 2010-07-13 |
| 1487965828 | Mehdi B Matin | Dentist | 4910 Directors Pl Ste 300, San Diego, CA 92121-3816 | 2010-06-30 |
| 1801125794 | Robert Henry Miner | Dentist | 12686 Picrus St, San Diego, CA 92129-4121 | 2009-12-24 |
| 1629205174 | Marc Dentico-olin | Dentist | 501 Washington St Ste 710, San Diego, CA 92103-2231 | 2009-06-11 |
| 1225272339 | Ruben Dario Ramirez | Dentist | 8008 Frost Street, Suite 311, San Diego, CA 92123 | 2009-04-21 |
| 1932352796 | Daniel S Witcher | Dentist | 4747 Orten St, San Diego, CA 92110-1322 | 2008-10-24 |
| 1669592853 | Raymichael Smith | Dentist | 16466 Bernardo Center Dr Ste 177, San Diego, CA 92128-2522 | 2007-03-30 |
| 1104962190 | Arshiya Sharafi | Dentist | 4910 Directors Pl, 301, San Diego, CA 92121-3811 | 2007-01-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.