Provider Demographics
NPI:1033236815
Name:CONTI, JOHN E (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:CONTI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5565 CARPINTERIA AVE
Mailing Address - Street 2:SUITE 21
Mailing Address - City:CARPINTERIA
Mailing Address - State:CA
Mailing Address - Zip Code:93013-1446
Mailing Address - Country:US
Mailing Address - Phone:805-684-5454
Mailing Address - Fax:805-566-1854
Practice Address - Street 1:5565 CARPINTERIA AVE
Practice Address - Street 2:SUITE 21
Practice Address - City:CARPINTERIA
Practice Address - State:CA
Practice Address - Zip Code:93013-1446
Practice Address - Country:US
Practice Address - Phone:805-684-5454
Practice Address - Fax:805-566-1854
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA247571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice