OrganizationActive
Mira Mesa Dental & Orthodontic Office
NPI 1124104336 · General Practice Dentistry · San Diego, CA
Provider details
- NPI number
- 1124104336
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Cynthia Johnson, Administrator(858) 566-5050
- License
- 20326 (CA)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
9750 Miramar Road
Suite 260
San Diego, CA 92126
Phone: (858) 566-5050
Fax: (858) 566-7414
Street-level locationGet directions
Mailing address
9750 Miramar Road
San Diego, CA 92126
Registry dates
- Enumerated
- 2006-10-31
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.