Derdivanis, John Peter
Derdivanis, John Peter is an individual health care provider with primary practice located at 15600 Washington Ave.Ste.E , San Lorenzo CA 94580. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Derdivanis, John Peter can be contacted via phone (510) 276-8366.Contact Information
Primary practice address
15600 Washington Ave.Ste.E
San Lorenzo CA 94580
Phone: (510) 276-8366
Fax: (510) 276-1422
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Periodontics | 1223P0300X | 15206 | California |
Profile Details
| NPI number | 1821024902 |
|---|---|
| LBN Legal business name | Derdivanis, John Peter |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 23rd, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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