Provider Demographics
NPI:1225121734
Name:LI, DAVID J (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:LI
Suffix:
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:16766 BERNARDO CENTER DR
Mailing Address - Street 2:#203A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2545
Mailing Address - Country:US
Mailing Address - Phone:858-487-8900
Mailing Address - Fax:858-487-7308
Practice Address - Street 1:16766 BERNARDO CENTER DR
Practice Address - Street 2:#203A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2545
Practice Address - Country:US
Practice Address - Phone:858-487-8900
Practice Address - Fax:858-487-7308
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA499301223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics