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General NPI Number Information
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NPI Number | 1013447879
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Entity Type | Organization
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Legal Business Name | JASON H NORDEAN DDS PLLC
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1950 W INDIAN SCHOOL RD SUITE 6
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City | PHOENIX
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State | AZ
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Zip | 85015
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Country | US
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Telephone | 602-650-1700
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Fax | 602-650-1704
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Provider Business Mailing Address
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Address Line | 1950 W INDIAN SCHOOL RD STE 6
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City | PHOENIX
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State | AZ
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Zip | 85015-5114
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Country | US
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Telephone | 602-650-1700
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Fax | 602-650-1704
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Authorized Official
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Title or Position | DENTAIST
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Name | DR. JASON H NORDEAN
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Credential | DDS
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Telephone | 602-650-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D008657
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License Number State | AZ
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