Provider Demographics
NPI:1124132543
Name:DANN, JOHN J (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:DANN
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Gender:M
Credentials:DMD, MD
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Mailing Address - Street 1:895 MORAGA RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-5094
Mailing Address - Country:US
Mailing Address - Phone:925-283-1212
Mailing Address - Fax:925-283-1217
Practice Address - Street 1:895 MORAGA RD
Practice Address - Street 2:SUITE 7
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-5094
Practice Address - Country:US
Practice Address - Phone:925-283-1212
Practice Address - Fax:925-283-1217
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2008-01-16
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Provider Licenses
StateLicense IDTaxonomies
CAG0413311223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1124132543Medicare PIN