NPI 1457218018 · live from the CMS NPI Registry
A Professional Dental Corporation
Dentist, Pediatric Dentistry in La Mesa, CA. National Provider Identifier 1457218018, active.
NPI record
| NPI | 1457218018 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Pediatric Dentistry 1223P0221X |
| Practice location | 8024 La Mesa Blvd, La Mesa, CA 91942 |
| Practice phone | 619-461-6166 |
| Enumerated | January 6, 2026 |
| Last updated | January 6, 2026 |
| Authorized official | Stephanie Talbot, Insurance Coordinator |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | — |
| Dentist, Pediatric Dentistry primary | 1223P0221X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.