Provider Demographics
NPI:1073723151
Name:HOSS, JOHN EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EDWARD
Last Name:HOSS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:7855 FAY AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4265
Mailing Address - Country:US
Mailing Address - Phone:858-454-7111
Mailing Address - Fax:858-454-7113
Practice Address - Street 1:7855 FAY AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4265
Practice Address - Country:US
Practice Address - Phone:858-454-7111
Practice Address - Fax:858-454-7113
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAD-183431223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics