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NPI Code Detail

MEDICARE: DR. JOHN BRANDON SKENANDORE DDS

MEDICARE:  DR. JOHN BRANDON SKENANDORE  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist103891CA

General Provider Information

NPI Number : 1093377111
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN BRANDON SKENANDORE DDS
Provider Business Mailing Address
First Line : 5247 LAMPSON AVE
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92845-1953
Country : US
Telephone Number : 714-893-2453
Fax Number :
Provider Business Practice Location Address
First Line : 5247 LAMPSON AVE
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92845-1953
Country : US
Telephone Number : 714-893-2453
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2019
Last Update Date : 04/22/2022

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Directions to “ DR. JOHN BRANDON SKENANDORE DDS” Practice Location

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