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General NPI Number Information
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NPI Number | 1669024063
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Entity Type | Individual
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Provider Name | JORDAN WADE ARDOIN DDS
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Gender | Male
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Dates
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Enumeration Date | 07/15/2019
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 4741 BUFFALO GAP RD
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City | ABILENE
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State | TX
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Zip | 79606-3304
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Country | US
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Telephone | 325-437-5284
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Fax |
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Provider Business Mailing Address
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Address Line | 4510 CROSLEY LN
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City | ABILENE
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State | TX
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Zip | 79606-4931
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Country | US
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Telephone | 915-261-9837
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 35301
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 35301
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License Number State | TX
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