Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. DOUG DISRAELI D.D.S.
NPI 1376547703
Dentist - General Practice in San Diego, CA

Q: What is Doug Disraeli's NPI number?

The NPI number for Doug Disraeli is 1376547703. It was assigned to this individual provider in the NPPES registry on June 13, 2005.

Q: What is Doug Disraeli'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 Doug Disraeli was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 30 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 June 13, 2005

3645 4TH AVE, SAN DIEGO, CA 92103(619) 291-2980(619) 291-2984 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Doug Disraeli D.d.s. NPPES

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

DR. DOUG DISRAELI D.D.S. (NPI 1376547703) is an individual general practice provider in San Diego, California, licensed in California (30322) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1376547703

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. DOUG DISRAELICredential: D.D.S.

Location Address3645 4TH AVESan Diego, CA 92103-4142

Mailing Address3645 4th AveSan Diego, CA 92103-4142 · (619) 291-2980 · Fax (619) 291-2984

Phone(619) 291-2980

Fax(619) 291-2984

Sole ProprietorNo

Enumeration DateJune 13, 2005

Last NPPES UpdateJuly 13, 2026

✔ NPI 1376547703 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 · 30322

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.

3645 4TH AVE, San Diego, CA 92103

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANDREW JACOB KEITH DDS

Dentist (General Practice)

3645 4TH AVE
SAN DIEGO, CA 92103

San Diego County (619) 291-2980

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 Doug Disraeli's NPI number?

The NPI number for Doug Disraeli is 1376547703. It was assigned to this individual provider in the NPPES registry on June 13, 2005.

Where is Doug Disraeli located?

Doug Disraeli practices at 3645 4th Ave, San Diego, CA 92103. The listed phone number is (619) 291-2980.

What is Doug Disraeli'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 Doug Disraeli was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 30 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.