Provider Demographics
NPI:1740338276
Name:CHRISPENS, JOHN BRANSON (DDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:BRANSON
Last Name:CHRISPENS
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 1:37 MARBELLA
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-4118
Mailing Address - Country:US
Mailing Address - Phone:949-240-2843
Mailing Address - Fax:
Practice Address - Street 1:2372 SE BRISTOL ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-0755
Practice Address - Country:US
Practice Address - Phone:949-833-2263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD206141223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics