Organization
JEPPESEN DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN JEPPESEN DMD (PRESIDENT)
(805) 644-2270
Entity
Organization
Contact information
Practice address
178 S VICTORIA AVE, SUITE D, VENTURA, CA 93003-4329
(805) 644-2270
(805) 644-2576
Mailing address
178 S VICTORIA AVE, SUITE D, VENTURA, CA 93003-4329
(805) 644-2270
(805) 644-2576
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
05/04/2010
Last updated
05/10/2011
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