Provider Demographics
NPI:1417930108
Name:SAUTER, JOHN DELL (DDS MDS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DELL
Last Name:SAUTER
Suffix:
Gender:M
Credentials:DDS MDS
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:DELL
Other - Last Name:SAUTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS MDS INC
Mailing Address - Street 1:20171 ORCHID ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660
Mailing Address - Country:US
Mailing Address - Phone:949-752-6262
Mailing Address - Fax:
Practice Address - Street 1:1330 SAN BERNADINO RD
Practice Address - Street 2:STE I
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786
Practice Address - Country:US
Practice Address - Phone:909-985-9215
Practice Address - Fax:949-857-1526
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA200004561223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics