Provider Demographics
NPI:1063657336
Name:SOTTOSANTI, JOHN SEBASTIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SEBASTIAN
Last Name:SOTTOSANTI
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 1:7877 IVANHOE AVE
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4528
Mailing Address - Country:US
Mailing Address - Phone:858-459-4364
Mailing Address - Fax:
Practice Address - Street 1:7877 IVANHOE AVE
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4528
Practice Address - Country:US
Practice Address - Phone:858-459-4364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA243451223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics