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General NPI Number Information
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NPI Number | 1902467475
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Entity Type | Individual
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Provider Name | RYAN JOHN COON D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 3906 STATE ST STE 103
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City | SANTA BARBARA
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State | CA
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Zip | 93105-3114
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Country | US
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Telephone | 805-687-6767
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Fax |
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Provider Business Mailing Address
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Address Line | 806 ORANGE AVE
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City | SANTA BARBARA
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State | CA
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Zip | 93101-4419
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Country | US
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Telephone | 515-210-8025
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 35208
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 110312
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License Number State | CA
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