Provider Demographics
NPI:1891702908
Name:JOHN J. MYERS, D.D.S., INC
Entity Type:Organization
Organization Name:JOHN J. MYERS, D.D.S., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-528-3311
Mailing Address - Street 1:17300 YORBA LINDA BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-3810
Mailing Address - Country:US
Mailing Address - Phone:714-528-3311
Mailing Address - Fax:714-528-9071
Practice Address - Street 1:17300 YORBA LINDA BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-3810
Practice Address - Country:US
Practice Address - Phone:714-528-3311
Practice Address - Fax:714-528-9071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA459321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty