Provider Demographics
NPI:1275778656
Name:SIEVER, JOHN THOMPSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:THOMPSON
Last Name:SIEVER
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 1:37 E OLIVE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-5282
Mailing Address - Country:US
Mailing Address - Phone:909-792-3748
Mailing Address - Fax:909-792-0498
Practice Address - Street 1:37 E OLIVE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5282
Practice Address - Country:US
Practice Address - Phone:909-792-3748
Practice Address - Fax:909-792-0498
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28815122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist