Provider Demographics
NPI:1396285284
Name:J.A. STRAW, D.D.S., INC.
Entity type:Organization
Organization Name:J.A. STRAW, D.D.S., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-990-3644
Mailing Address - Street 1:16300 SAND CANYON AVE STE 711
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3707
Mailing Address - Country:US
Mailing Address - Phone:949-727-7000
Mailing Address - Fax:949-727-3924
Practice Address - Street 1:16300 SAND CANYON AVE STE 711
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3707
Practice Address - Country:US
Practice Address - Phone:949-727-7000
Practice Address - Fax:949-727-3924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA527821223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty