Healthcare Provider Details

I. General information

NPI: 1659584654
Provider Name (Legal Business Name): JOHN E HUNTSINGER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 CALLE TECATE STE 206
CAMARILLO CA
93012-5286
US

IV. Provider business mailing address

5434 CHERRY RIDGE DR
CAMARILLO CA
93012-5510
US

V. Phone/Fax

Practice location:
  • Phone: 805-379-1989
  • Fax: 805-379-1988
Mailing address:
  • Phone: 805-231-8508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6978
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number29949
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: