Adam Takeo Ellenthal is a San Diego, California based Pediatric Dentist who is specialized in
Pediatric Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Adam Takeo Ellenthal is
111647 for Pediatric Dentistry in California. His current practice location is
10717 Camino Ruiz Ste 103, San Diego. Patients can reach him at
858-536-1111.
Adam Takeo Ellenthal provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Profile:
Adam Takeo Ellenthal speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Adam Takeo Ellenthal |
| Specialization: | Pediatric Dentist |
| Gender: | Male |
| Credentials: | DDS, MPH |
| Accepts Medicare Assignment: | No |
| Practice Address: | 10717 Camino Ruiz Ste 103, San Diego,
California, 92126-2310 |
| Phone: | 858-536-1111 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1447884861 |
| NPI Enumeration Date: | 25 Feb, 2020 |
| NPI Last Update On: | 18 May, 2026 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Adam Takeo Ellenthal are as mentioned below.
| License Number | Specialization | State | Status | |
| 111647 | Pediatric Dentistry | California | Primary | |
| Student in an Organized Health Care Education/Training Program | | Secondary | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 13308 Entreken Ave,
San Diego, California |
| Zip: | 92129-2354 |
| Phone Number: | 954-850-2669 |
Patients can reach Adam Takeo Ellenthal at
10717 Camino Ruiz Ste 103, San Diego, California or can
call to book an appointment on 858-536-1111.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
13 July, 2026.