Healthcare Provider Details

I. General information

NPI: 1801336433
Provider Name (Legal Business Name): JAYME JO JOHNSON DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JAYME JO NOESKE DMD

II. Dates (important events)

Enumeration Date: 03/01/2017
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 KINMAN AVE
GOLETA CA
93117-3481
US

IV. Provider business mailing address

414 E COTA ST FL 1
SANTA BARBARA CA
93101-1624
US

V. Phone/Fax

Practice location:
  • Phone: 805-617-7898
  • Fax: 805-617-7899
Mailing address:
  • Phone: 805-617-7898
  • Fax: 805-617-7899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberD14011
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: