Provider Demographics
NPI:1922140391
Name:DUENES, JOSE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:M
Last Name:DUENES
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 1:3502 COLLEGE BLVD
Mailing Address - Street 2:#B
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4671
Mailing Address - Country:US
Mailing Address - Phone:760-941-7502
Mailing Address - Fax:760-940-2704
Practice Address - Street 1:3502 COLLEGE BLVD
Practice Address - Street 2:#B
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4671
Practice Address - Country:US
Practice Address - Phone:760-941-7502
Practice Address - Fax:760-940-2704
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35047122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9139801OtherMEDI CAL