Provider Demographics
NPI:1407997976
Name:SPARROW, JOSEPH S (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:S
Last Name:SPARROW
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 1:3292 SANDROCK RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-3066
Mailing Address - Country:US
Mailing Address - Phone:858-277-7474
Mailing Address - Fax:858-277-7478
Practice Address - Street 1:3292 SANDROCK RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-3066
Practice Address - Country:US
Practice Address - Phone:858-277-7474
Practice Address - Fax:858-277-7478
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA480241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice