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General NPI Number Information
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NPI Number | 1144974312
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Entity Type | Individual
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Provider Name | JEFFREY GEORGE KOVAL JR. DDS
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Gender | Male
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Dates
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Enumeration Date | 02/07/2022
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 1401 AVOCADO AVE STE 603
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-8715
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Country | US
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Telephone | 805-807-2082
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Fax |
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Provider Business Mailing Address
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Address Line | 5 DUXBURY ST
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City | LADERA RANCH
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State | CA
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Zip | 92694-1061
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Country | US
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Telephone | 805-807-2082
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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 | 108463
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License Number State | CA
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