Individual provider Active NPI

John Hall Phreaner, DDS

  • General Practice Dentistry
  • Santa Barbara, CA
National Provider Identifier
1356495360
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29653 Issued in CA
Practice address
1515 State St
Suite 18
Santa Barbara, CA 93101-2536
Phone
(805) 963-5934
Fax
(805) 966-9808
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 29653 CA Primary

Addresses

Primary practice location

1515 State St
Suite 18
Santa Barbara, CA 93101-2536

Mailing address

1515 State St
Suite 18
Santa Barbara, CA 93101-2536
Phone (805) 963-5934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Feb 15, 2016 through Feb 15, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356495360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 STATE ST",
            "address_2": "SUITE 18",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931012536",
            "telephone_number": "805-963-5934",
            "fax_number": "805-966-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 STATE ST",
            "address_2": "SUITE 18",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931012536",
            "telephone_number": "805-963-5934",
            "fax_number": "805-966-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHREANER",
        "first_name": "JOHN",
        "middle_name": "HALL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.