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NPI Code Detail

MEDICARE: JORDAN SALOW MCWHORTER RDH

MEDICARE:   JORDAN SALOW MCWHORTER  RDH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1124Q00000XDental Hygienist30639CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1011641579-02OTHERCATRICARE

General Provider Information

NPI Number : 1083144646
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN SALOW MCWHORTER RDH
Provider Business Mailing Address
First Line : PSC 559 BOX 6224
Second Line :
City : FPO
State : AP
Zip : 96377-0063
Country : US
Telephone Number : 760-420-7624
Fax Number :
Provider Business Practice Location Address
First Line : BUILDING 236
Second Line :
City : YOMITAN-SON NAKAGAMI-GUN
State : OKINAWA
Zip : 96376
Country : JP
Telephone Number : 644-411-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2017
Last Update Date : 07/21/2022

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Directions to “ JORDAN SALOW MCWHORTER RDH” Practice Location

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