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Dr. John Peter Derdivanis, DDS
Periodontist in San Lorenzo, California
NPI 1821024902

John Peter Derdivanis is a Periodontist based in San Lorenzo, CA and is specialized in Periodontics. John Peter Derdivanis practices in San Lorenzo, CA and has the professional credentials of DDS. The NPI Number for John Peter Derdivanis is 1821024902 and holds a License No. 15206 (California).

The current practice location address for John Peter Derdivanis is 15600 Washington Ave.ste.e, San Lorenzo, CA and can be reached out via phone at 510-276-8366 and via fax at 510-276-1422.

Location: 15600 Washington Ave.ste.e, San Lorenzo, CA, 94580
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821024902
Provider Name
John Peter Derdivanis
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
15600 Washington Ave.ste.e, San Lorenzo, CA, 94580
Phone Number
510-276-8366
Fax Number
510-276-1422
Provider Enumeration Date
06/23/2006
Last Update Date
11/16/2024
institution
Provider Business Practice Location Address Details
Address
15600 Washington Ave.ste.e
City
San Lorenzo
State
California
Zip
94580
Phone Number
510-276-8366
Fax Number
510-276-1422
person
Provider Business Mailing Address Details
Address
15600 Washington Ave.ste.e
City
San Lorenzo
State
California
Zip
94580
Phone Number
510-276-8366
Fax Number
510-276-1422
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Periodontics
Taxonomy
1223P0300X
License No.
15206 (California)
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
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