Provider Demographics
NPI:1013911833
Name:STAPLES, JEFFREY JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:JOHN
Last Name:STAPLES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:27001 LA PAZ RD
Mailing Address - Street 2:STE 236
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-5537
Mailing Address - Country:US
Mailing Address - Phone:949-768-0211
Mailing Address - Fax:949-768-7531
Practice Address - Street 1:27001 LA PAZ RD
Practice Address - Street 2:STE 236
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5537
Practice Address - Country:US
Practice Address - Phone:949-768-0211
Practice Address - Fax:949-768-7531
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA246101223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics