Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

DR. KETAN JAGJIVAN MISTRY
NPI 1104747922
Dentist - General Practice in San Diego, CA

Q: What is Ketan Mistry's NPI number?

The NPI number for Ketan Mistry is 1104747922. It was assigned to this individual provider in the NPPES registry on July 25, 2026.

Q: What is Ketan Mistry's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Ketan Mistry was last updated on July 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 25 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 25, 2026

3737 MORAGA AVE STE B309, SAN DIEGO, CA 92117(858) 581-3641 Get Directions Write a Review

NPPES record added: July 25, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Ketan Jagjivan Mistry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KETAN JAGJIVAN MISTRY (NPI 1104747922) is an individual general practice provider in San Diego, California, licensed in California (110915) and active in the NPI registry since July 2026.

NPPES Registry Identity

NPI1104747922

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. KETAN JAGJIVAN MISTRY

Location Address3737 MORAGA AVE STE B309San Diego, CA 92117-5478

Mailing Address3737 Moraga Ave Ste B309San Diego, CA 92117-5478 · (858) 581-3641

Phone(858) 581-3641

Sole ProprietorNo

Enumeration DateJuly 25, 2026

NPPES CertifiedJuly 25, 2026

✔ NPI 1104747922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CA · 110915

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

3737 MORAGA AVE STE B309, San Diego, CA 92117

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ketan Mistry's NPI number?

The NPI number for Ketan Mistry is 1104747922. It was assigned to this individual provider in the NPPES registry on July 25, 2026.

Where is Ketan Mistry located?

Ketan Mistry practices at 3737 Moraga Ave Ste B309, San Diego, CA 92117. The listed phone number is (858) 581-3641.

What is Ketan Mistry's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Ketan Mistry was last updated on July 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 25 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.