The register record
- Register kind
- Prosthodontist
- Practice address
- 43000 Midway Ave Bldg 595, Marine Corps Recruit Depot, San Diego, CA 92140
- Phone
- (619) 524-4009
- NPI
- 1104994474
- License
- 4584 as shown in the register — verify it at the California license lookup
- In the register since
- December 2, 2006
- Record last updated
- July 8, 2007
- Read by us
- September 29, 2026
What a prosthodontist is
A prosthodontist is a dentist with years of further specialty training in restoring and replacing teeth — the recognized dental specialty behind complete dentures, partial dentures, implant-supported dentures and full-mouth reconstruction. The register lists this provider under the prosthodontics taxonomy; it does not say what they charge or which treatments they currently offer, so ask directly.
This page shows the NPPES NPI register record as we read it on September 29, 2026, and nothing else: no ratings, no reviews, and no payment for placement. CMS notes that holding an NPI does not ensure or validate licensure or credentials. If this is your record and something is wrong, tell us and we will correct or remove it against the register.
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