A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation’s Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Dentist Anesthesiologist | 1223D0004X |
| Dentist | 122300000X | |
| Student in an Organized Health Care Education/Training Program | 390200000X |
* Indicates primary specialty
| NPI Number | 1215463575 |
| Credentials | DDS (Doctor of Dental Surgery) |
| Entity | Individual |
| Enumeration date | 05/05/2017 |
| Last updated | 07/25/2025 - About 10 months ago |
| Sole proprietor1 | No |
| Identifiers |
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| Hospital affiliation | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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