Provider Demographics
NPI:1558575860
Name:BRINEY, JEFFREY RICHARD
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:RICHARD
Last Name:BRINEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24921 DANA POINT HARBOR DR STE B-120
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2933
Mailing Address - Country:US
Mailing Address - Phone:949-496-0131
Mailing Address - Fax:
Practice Address - Street 1:24921 DANA POINT HARBOR DR STE B-120
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-2933
Practice Address - Country:US
Practice Address - Phone:949-496-0131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43424122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist