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General NPI Number Information
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NPI Number | 1881231454
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Entity Type | Organization
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Legal Business Name | JORDYN & TAYLOR FAMILY DENTAL, PLLC
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Dates
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Enumeration Date | 12/03/2019
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Last Update Date | 02/01/2025
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Provider Practice Location Address
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Address Line | 21070 N PIMA RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-6617
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Country | US
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Telephone | 480-659-9499
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Fax |
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Provider Business Mailing Address
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Address Line | 36815 N BOULDER VIEW DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85262-3913
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Country | US
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Telephone | 530-300-2200
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | TAYLOR FUNK
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Credential | DMD
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Telephone | 530-300-2200
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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 |
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License Number State |
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