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General NPI Number Information
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NPI Number | 1316866825
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Entity Type | Organization
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Legal Business Name | JPDMD PC
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Dates
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Enumeration Date | 07/10/2026
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Last Update Date | 07/10/2026
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Provider Practice Location Address
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Address Line | 4735 N SUMMIT WAY SUITE 100
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City | MERIDIAN
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State | ID
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Zip | 83646
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Country | US
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Telephone | 208-888-0662
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Fax | 208-888-0863
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Provider Business Mailing Address
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Address Line | 4795 N SUMMIT WAY STE 120
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City | MERIDIAN
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State | ID
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Zip | 83646-6697
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Country | US
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Telephone | 208-888-0662
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Fax | 208-888-0863
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Authorized Official
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Title or Position | OWNER
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Name | DR. JORDAN KENT PILLING
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Credential | DMD
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Telephone | 208-670-4276
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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 |
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License Number State |
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