Provider Demographics
NPI:1083822191
Name:MONSEF, JAY J (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:J
Last Name:MONSEF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:JAY
Other - Middle Name:J
Other - Last Name:MONSEF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:235 S HIGHWAY 101
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1807
Mailing Address - Country:US
Mailing Address - Phone:858-509-1113
Mailing Address - Fax:858-356-1301
Practice Address - Street 1:235 S HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1807
Practice Address - Country:US
Practice Address - Phone:858-509-1113
Practice Address - Fax:858-356-1301
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA255991223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics