Provider Demographics
NPI:1104138684
Name:JONES, SAMANTHA BRENNER (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:BRENNER
Last Name:JONES
Suffix:
Gender:F
Credentials:DDS, MD
Other - Prefix:DR
Other - First Name:SAMANTHA
Other - Middle Name:ERIN
Other - Last Name:BRENNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:470 MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-1735
Mailing Address - Country:US
Mailing Address - Phone:203-520-1339
Mailing Address - Fax:
Practice Address - Street 1:680 ALAMO PINTADO RD
Practice Address - Street 2:SUITE #105
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-2204
Practice Address - Country:US
Practice Address - Phone:805-697-7412
Practice Address - Fax:805-691-9206
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA585521223G0001X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice