Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 58552 | CA |
N | 213EG0000X | General Practice | 58552 | CA |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 58552 | CA |
NPI | 1104138684 |
---|---|
Provider Name | Dr. Samantha Brenner Jones |
First Address | Santa Barbara, CA 93103-1735 |
Second Address | Solvang, CA 93463-2204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2010 |
Last Update Date | 22/08/2016 |