Provider Demographics
NPI:1710016217
Name:GRIFFING, JOHN FERNANDO (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FERNANDO
Last Name:GRIFFING
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 1:1816 AVENIDA LA POSTA
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-7111
Mailing Address - Country:US
Mailing Address - Phone:760-479-0536
Mailing Address - Fax:
Practice Address - Street 1:530 LOMAS SANTA FE DR
Practice Address - Street 2:SUITE # 5
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1349
Practice Address - Country:US
Practice Address - Phone:858-755-7149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA468101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice