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General NPI Number Information
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NPI Number | 1023898269
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Entity Type | Individual
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Provider Name | JOURDON BEAN DMD
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Gender | Male
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Dates
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Enumeration Date | 10/04/2023
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 40250 MURRIETA HOT SPRINGS RD STE 119
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City | MURRIETA
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State | CA
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Zip | 92563-4963
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Country | US
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Telephone | 951-498-3216
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Fax |
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Provider Business Mailing Address
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Address Line | 41296 RUE JADOT
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City | TEMECULA
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State | CA
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Zip | 92591-5917
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Country | US
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Telephone | 405-642-5221
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 109132
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License Number State | CA
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