Provider Demographics
NPI:1912142282
Name:JOHN E. LOFTHUS, DDS, INC.
Entity Type:Organization
Organization Name:JOHN E. LOFTHUS, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:LOFTHUS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-459-4364
Mailing Address - Street 1:7877 IVANHOE AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4528
Mailing Address - Country:US
Mailing Address - Phone:858-459-4364
Mailing Address - Fax:
Practice Address - Street 1:7877 IVANHOE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4528
Practice Address - Country:US
Practice Address - Phone:858-459-4364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA336211223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty