Healthcare Provider Details

I. General information

NPI: 1780716878
Provider Name (Legal Business Name): JEFFREY JAMES BORANDI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 08/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 EMERSON DR
ZELIENOPLE PA
16063-1406
US

IV. Provider business mailing address

10154 WOODBURY DRIVE
WEXFORD PA
15090
US

V. Phone/Fax

Practice location:
  • Phone: 724-452-7887
  • Fax: 724-452-6803
Mailing address:
  • Phone: 724-759-7948
  • Fax: 724-759-7952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS036141
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License NumberDS036141
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: