Healthcare Provider Details

I. General information

NPI: 1306988225
Provider Name (Legal Business Name): DONALD JOHN HORN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 G ST
SAN DIEGO CA
92101-7434
US

IV. Provider business mailing address

700 W HARBOR DR UNIT 702
SAN DIEGO CA
92101-7755
US

V. Phone/Fax

Practice location:
  • Phone: 619-324-4981
  • Fax:
Mailing address:
  • Phone: 727-647-1633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDDS111685
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: