Provider Demographics
NPI:1518275460
Name:HOFF, JEREMY MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:MICHAEL
Last Name:HOFF
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 1:1895 ORANGE TREE LN
Mailing Address - Street 2:SUITE 203
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-0111
Mailing Address - Country:US
Mailing Address - Phone:909-307-5353
Mailing Address - Fax:909-307-5388
Practice Address - Street 1:1895 ORANGE TREE LN
Practice Address - Street 2:SUITE 203
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-0111
Practice Address - Country:US
Practice Address - Phone:909-307-5353
Practice Address - Fax:909-307-5388
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59758122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist