Healthcare Provider Details

I. General information

NPI: 1811308968
Provider Name (Legal Business Name): JORDAN A. LAMBERTON D.D.S., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2014
Last Update Date: 09/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3270 BEARD RD.
NAPA CA
94558
US

IV. Provider business mailing address

3270 BEARD RD.
NAPA CA
94558
US

V. Phone/Fax

Practice location:
  • Phone: 707-226-5555
  • Fax: 707-226-5555
Mailing address:
  • Phone: 707-226-5555
  • Fax: 707-226-5555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number61054
License Number StateCA

VIII. Authorized Official

Name: DR. JORDAN LAMBERTON
Title or Position: OWNER/ORTHODONTIST
Credential: D.D.S., M.S.D.
Phone: 707-226-5555