BRADLEY A. ELI DENTAL CORPORATION (NPI# 1962533919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962533919 |
| Entity Type | Organization |
| Organization Name | BRADLEY A. ELI DENTAL CORPORATION |
| Practice Address |
4403 Manchester Ave Suite 101 Encinitas CA 92024-4939 |
| Practice Telephone | 7604366365 |
| Practice Fax Number | 7604365123 |
| Mailing Telephone | 7604366365 |
| Mailing Fax Number | 7604365123 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2019-10-09 |
| Authorized Official Name | DR. BRADLEY ALLEN ELI (PRESIDENT) |
| Authorized Official Telephone | 7604364062 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DS36308 | CA | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 35400 Bob Hope Dr Ste 204, Rancho Mirage, CA 922701774 | 7604366365 | 7604365123 |
| 44100d Jefferson St Ste 404, Indio, CA 922012700 | 7604366365 | 7604365123 |
| Street Address |
4403 MANCHESTER AVE SUITE 101 |
| City | ENCINITAS |
| State | CA |
| Zip Code | 92024-4939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205948270 | Bradley A Eli | Specialist | 4403 Manchester Ave, Suite 101, Encinitas, CA 92024-4939 | 2006-08-31 |
| 1922361039 | Majel Josephine Miskinis | Community Health Worker | 4403 Manchester Ave, Suite 103, Encinitas, CA 92024-4939 | 2012-06-22 |
| 1821394933 | Carey Alexander O'rielly | Dentist | 4403 Manchester Ave, Suite 206-b, Encinitas, CA 92024-4939 | 2011-02-07 |
| 1114042769 | Adam D Fogelman | Chiropractor | 4403 Manchester Ave, Suite 107, Encinitas, CA 92024-4939 | 2007-03-20 |
| 1053440024 | Mark Drucker | General Practice | 4403 Manchester Ave, Ste. 107, Encinitas, CA 92024-4939 | 2007-03-05 |
| 1083741854 | Linda E. Langhorn | Acupuncturist | 4403 Manchester Ave, Ste 208, Encinitas, CA 92024-4939 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326688672 | Erika S Roark | Nurse Practitioner | 754 Bonita Drive, Encinitas, CA 92024 | 2020-01-14 |
| 1871064279 | Elana Miller | Physical Therapist | 285 N El Camino Real Ste 202, Encinitas, CA 92024 | 2018-12-10 |
| 1811478654 | Aton Center, Inc. | Substance Abuse Rehabilitation Facility | 3238 Country Rose Cir, Encinitas, CA 92024 | 2018-08-28 |
| 1124508296 | Hardison Medical Corporation | Family Medicine | 2210 Encinitas Blvd Ste N, Encinitas, CA 92024 | 2018-08-18 |
| 1326544990 | Jamin Sarah Sylvada | Midwife | 1141 Balour Drive, Encinitas, CA 92024 | 2018-04-03 |
| 1457856445 | Stephanie Yarnell | Optometrist | 385 Via Montanosa, Encinitas, CA 92024 | 2018-03-29 |
| 1972002954 | J Schaefer Dds Inc | Clinic/Center | 355 Santa Fe Drive Suite 100, Encinitas, CA 92024 | 2018-02-06 |
| 1538691654 | Dr. James C. Lajevic D.m.d. Correct Choice Dental | Point of Service | 199 N El Camino Real Blvd, Suite E, Encinitas, CA 92024 | 2017-03-29 |
| 1649720566 | Marcia A. Rebelo | Social Worker | 187 Calle Magdalena Ste 114, Encinitas, CA 92024 | 2016-10-04 |
| 1346698529 | Jordan Anne Pinozek | Optometrist | 1044b N El Camino Real, Encinitas, CA 92024 | 2016-05-29 |
| Find all providers in zip 92024 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013565043 | Christopher Demeyer | Dentist | 1340 Encinitas Blvd Unit 100, Encinitas, CA 92024-2844 | 2019-09-03 |
| 1659744639 | Su Gao | Dentist | 199 N El Camino Real, Suite E, Encinitas, CA 92024-2803 | 2015-11-12 |
| 1295113736 | Corey Roberson | Dentist | 1340 Encinitas Blvd Ste 100, Encinitas, CA 92024-2844 | 2015-05-17 |
| 1578958823 | Todd Morgan Dental Corporation | Dentist | 320 Sante Fe Drive, Suite 105, Encinitas, CA 92024 | 2015-04-03 |
| 1063801025 | J Maroon Dds Inc | Dentist | 257 N El Camino Real Ste B, Encinitas, CA 92024-5365 | 2015-01-14 |
| 1275946501 | Farhad Dena | Dentist | 1403 Encintas Blvd., Suite D, Encinitas, CA 92024 | 2014-06-04 |
| 1699052845 | Mark Thomas Galli | Dentist | 171 Calle Magdalena, Ste 102, Encinitas, CA 92024-3745 | 2011-11-15 |
| 1043522709 | Mark E Loomis | Dentist | 4455 Manchester Ave, Encinitas, CA 92024-4934 | 2010-07-10 |
| 1417141151 | Beth Sandra Forman | Dentist | 679 Encinitas Blvd, Suite 209, Encinitas, CA 92024-3761 | 2007-09-05 |
| 1811198823 | Diemphi Nguyen | Dentist | 1610 Willowhaven Rd, Encinitas, CA 92024-5646 | 2007-05-29 |
| Find all providers in ENCINITAS | ||||
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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.