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General NPI Number Information
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NPI Number | 1922784297
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Entity Type | Individual
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Provider Name | HANNAH LEANN JORDAN DMD
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Gender | Female
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Dates
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Enumeration Date | 06/22/2023
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 601 N LONGSTREET ST
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City | KINGSTREE
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State | SC
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Zip | 29556-3303
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Country | US
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Telephone | 843-355-7606
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Fax | 843-355-7506
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Provider Business Mailing Address
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Address Line | 601 N LONGSTREET ST
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City | KINGSTREE
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State | SC
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Zip | 29556-3303
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Country | US
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Telephone | 843-355-7606
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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 | DGD.10547
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License Number State | SC
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