MEDICARE: JOURDON BEAN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	109132	CA

General Provider Information

NPI Number	:	1023898269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOURDON BEAN DMD

Provider Business Mailing Address
First Line	:	41296 RUE JADOT
Second Line	:
City	:	TEMECULA
State	:	CA
Zip	:	92591-5917
Country	:	US
Telephone Number	:	405-642-5221
Fax Number	:

Provider Business Practice Location Address
First Line	:	40250 MURRIETA HOT SPRINGS RD STE 119
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92563-4963
Country	:	US
Telephone Number	:	951-498-3216
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2023
Last Update Date	:	10/04/2023

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