BRANCH DENTAL CLINIC EDSON RANGE ANNEX – NPI #1558548008
Clinic/Center

BRANCH DENTAL CLINIC EDSON RANGE ANNEX is an AHC clinic located in CAMP PENDLETON, CA. NPPES has assigned the NPI number 1558548008 to BRANCH DENTAL CLINIC EDSON RANGE ANNEX on January 28, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

The NPI profile was previously updated about 8 years ago on May 25, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BRANCH DENTAL CLINIC EDSON RANGE ANNEX below.

NPI Profile for
BRANCH DENTAL CLINIC EDSON RANGE ANNEX

NPI Number
1558548008
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BRANCH DENTAL CLINIC EDSON RANGE ANNEX
Primary location
14TH STREET
BUILDING 13128
CAMP PENDLETON, CA 92055
Phone: (760) 725-3213 Fax: (760) 725-8223
Mailing address
PO BOX 555221
CAMP PENDLETON, CA 92055-5221
Phone: (760) 725-3213 Fax: (760) 725-8223
Organization Subpart
Yes - BRANCH DENTAL CLINIC EDSON RANGE ANNEX is subpart of another organization.
Authorized Official
WILLIAM CONDON
NAVY MEDICINE UBO PROGRAM MANAGER
Phone: (240) 401-3643
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.