Healthcare Provider Details

I. General information

NPI: 1932252830
Provider Name (Legal Business Name): PAUL D DANKEMEYER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 01/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 VIA JUANA RD
SANTA YNEZ CA
93460-9679
US

IV. Provider business mailing address

PO BOX 90 90 VIA JUANA LANE
SANTA YNEZ CA
93460-0090
US

V. Phone/Fax

Practice location:
  • Phone: 805-688-7070
  • Fax: 805-686-2060
Mailing address:
  • Phone: 805-688-7070
  • Fax: 805-686-2060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD6714
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number55491
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: