MEDICARE: JORDAN POND DMD

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
1	122300000X	Dentist	D008952	AZ

General Provider Information

NPI Number	:	1104237593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN POND DMD

Provider Business Mailing Address
First Line	:	3787 E CULLUMBER ST
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85234-4318
Country	:	US
Telephone Number	:	480-294-5686
Fax Number	:

Provider Business Practice Location Address
First Line	:	9221 E BASELINE RD
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85209-8310
Country	:	US
Telephone Number	:	480-357-7759
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2014
Last Update Date	:	01/13/2015

Similar Medicare Providers

1427752476 — DR. SAMANTHA KALILIKANE PSY.D.
Practice Location Address:

9221 E BASELINE RD STE 109-248
MESA, AZ
85209-8310

Practice Phone: 727-416-1642
Practice Fax:

1598924557 — DR. JOHN PETER RUKAVENA PHARMD
Practice Location Address:

9221 E BASELINE RD , A109255
MESA, AZ
85209-8310

Practice Phone: 315-542-2121
Practice Fax:

1336524636 — BRAMWELL DENTISTRY
Practice Location Address:

9221 E BASELINE RD , 111
MESA, AZ
85209-8310

Practice Phone: 480-357-7759
Practice Fax: 480-422-7391

1477043255 — ABA SCHOOLHOUSE
Practice Location Address:

9221 E BASELINE RD STE 109NO242
MESA, AZ
85209-8310

Practice Phone: 805-325-1421
Practice Fax: 480-939-3596

1790570919 — IMUA CENTER, LLC
Practice Location Address:

9221 E BASELINE RD STE 109-248
MESA, AZ
85209-8310

Practice Phone: 727-416-1642
Practice Fax:

1396612867 — VITAL TURN LLC
Practice Location Address:

9221 E BASELINE RD # 440
MESA, AZ
85209-8310

Practice Phone: 480-799-3443
Practice Fax:

Directions to “ JORDAN POND DMD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.