Provider Demographics
NPI:1932252830
Name:DANKEMEYER, PAUL D (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:DANKEMEYER
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:PO BOX 90
Mailing Address - Street 2:90 VIA JUANA LANE
Mailing Address - City:SANTA YNEZ
Mailing Address - State:CA
Mailing Address - Zip Code:93460-0090
Mailing Address - Country:US
Mailing Address - Phone:805-688-7070
Mailing Address - Fax:805-686-2060
Practice Address - Street 1:90 VIA JUANA RD
Practice Address - Street 2:
Practice Address - City:SANTA YNEZ
Practice Address - State:CA
Practice Address - Zip Code:93460-9679
Practice Address - Country:US
Practice Address - Phone:805-688-7070
Practice Address - Fax:805-686-2060
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD67141223G0001X
CA554911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ113955Medicaid