| Excel Dental Escondido | |
|
9225 Mira Mesa Blvd Ste 103 San Diego CA 92126-4810 | |
| (858) 566-7645 | |
| Not Available |
| Full Name | Excel Dental Escondido |
|---|---|
| Speciality | Dentist |
| Location | 9225 Mira Mesa Blvd Ste 103, San Diego, California |
| Authorized Official Name and Position | Jennifer Trang Xa (CEO/PRESIDENT) |
| Authorized Official Contact | 8585667645 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Excel Dental Escondido 9225 Mira Mesa Blvd Suite 103 San Diego CA 92126-4820 Ph: (858) 566-7645 | Excel Dental Escondido 9225 Mira Mesa Blvd Ste 103 San Diego CA 92126-4810 Ph: (858) 566-7645 |
| NPI Number | 1740441070 |
|---|---|
| Provider Enumeration Date | 06/19/2008 |
| Last Update Date | 09/05/2024 |
| Medicare PECOS PAC ID | 8123446424 |
|---|---|
| Medicare Enrollment ID | O20200918001170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740441070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 48407 (California) | Primary |
| Provider Name | Jennifer Trang Xa |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1922160050 PECOS PAC ID: 9032537337 Enrollment ID: I20200918001259 |
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