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General NPI Number Information
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NPI Number | 1366478828
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Entity Type | Organization
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Legal Business Name | JEFFREY J ORCHEN DDS INC
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 5525 WARRENSVILLE CENTER ROAD
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City | MAPLE HEIGHTS
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State | OH
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Zip | 44137-3125
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Country | US
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Telephone | 216-663-1967
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Fax | 216-663-1819
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Provider Business Mailing Address
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Address Line | 5525 WARRENSVILLE CENTER ROAD
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City | MAPLE HEIGHTS
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State | OH
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Zip | 44137-3125
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Country | US
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Telephone | 216-663-1967
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Fax | 216-663-1819
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KRISTY LYNN FAKADEJ
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Credential |
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Telephone | 216-663-1967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 15639
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License Number State | OH
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