Provider Demographics
NPI:1962645036
Name:HIPPENSTEEL, JOSEPH C II
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:C
Last Name:HIPPENSTEEL
Suffix:II
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 1:945 HORNBLEND ST
Mailing Address - Street 2:A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-4057
Mailing Address - Country:US
Mailing Address - Phone:858-270-6755
Mailing Address - Fax:
Practice Address - Street 1:945 HORNBLEND ST
Practice Address - Street 2:A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-4057
Practice Address - Country:US
Practice Address - Phone:858-270-6755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-19
Last Update Date:2009-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16179122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist