Dr. Edithann Jennings Graham
Periodontist
1806 Cable St
San Diego
, California 92107-3103
Dr. Edithann Jennings Graham
Periodontist
1806 Cable St
San Diego
, California 92107-3103
(619) 226-3027
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Edithann Jennings Graham
- 1806 Cable St
- San Diego, CA
- Zip : 92107-3103
- Fax : (619) 226-3027
- Phone : (619) 226-4784
Second Address
- Dr. Edithann Jennings Graham
- 1806 Cable St
- San Diego, CA
- Zip : 92107-3103
- Fax : (619) 226-3027
- Phone : (619) 226-4784
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 1223P0300X | Periodontist | 5253 | AZ |
| Y | 1223P0300X | Periodontist | CA56651 | CA |
National Provider Identifier
| NPI | 1063490639 |
|---|---|
| Provider Name | Dr. Edithann Jennings Graham |
| First Address | San Diego, CA 92107-3103 |
| Second Address | San Diego, CA 92107-3103 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/01/2006 |
| Last Update Date | 17/07/2009 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.