Healthcare Provider Details

I. General information

NPI: 1003344300
Provider Name (Legal Business Name): JORDAN JOSEPH TELIN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7535 CARPENTER FIRE STATION RD
CARY NC
27519-8968
US

IV. Provider business mailing address

2504 MAGNOLIA TREE LN
DURHAM NC
27703-6421
US

V. Phone/Fax

Practice location:
  • Phone: 919-846-7900
  • Fax:
Mailing address:
  • Phone: 412-992-0783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN10001339
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: