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General NPI Number Information
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NPI Number | 1972814820
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Entity Type | Individual
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Provider Name | JORDAN HESTER D.M.D
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Gender | Male
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Dates
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Enumeration Date | 06/25/2010
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 7505 GRAND LELY DR BLDG L
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City | NAPLES
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State | FL
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Zip | 34113-1753
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Country | US
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Telephone | 239-775-3052
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Fax | 239-775-7035
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Provider Business Mailing Address
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Address Line | 1454 MADISON AVE W
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City | IMMOKALEE
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State | FL
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Zip | 34142-2200
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Country | US
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Telephone | 239-658-3000
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Fax | 239-658-3175
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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 | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 19083
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License Number State | FL
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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 | DN19083
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License Number State | FL
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