# BRADLEY A. ELI DENTAL CORPORATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962533919
- **Authorized official:** DR. BRADLEY ALLEN ELI DMD (PRESIDENT)
- **Authorized official phone:** (760) 436-4062

## Contact information

- **Practice address:** 2095 W VISTA WAY STE 218, VISTA, CA 92083-6029
- **Practice address phone:** (760) 436-6365
- **Practice address fax:** (760) 436-5123
- **Mailing address:** 2095 W VISTA WAY STE 218, VISTA, CA 92083-6029
- **Mailing address phone:** (760) 436-6365
- **Mailing address fax:** (760) 436-5123

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |
| 1223X2210X | Orofacial Pain Dentistry | — | NULL | Yes |
| 1223X2210X | Orofacial Pain Dentistry | — | — | Yes |
| 125Q00000X | Oral Medicine Dentistry | — | NULL | — |
| 125Q00000X | Oral Medicine Dentistry | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/08/2007
- **Last updated:** 05/11/2026