Provider Demographics
NPI:1902922768
Name:HENNO, JOHN CHRISTIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHRISTIAN
Last Name:HENNO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1532 ANACAPA ST
Mailing Address - Street 2:#2
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-1929
Mailing Address - Country:US
Mailing Address - Phone:805-965-9878
Mailing Address - Fax:
Practice Address - Street 1:1532 ANACAPA ST
Practice Address - Street 2:#2
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1929
Practice Address - Country:US
Practice Address - Phone:805-965-9878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice