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NPI Code Detail

MEDICARE: DENNIS JORDANIDES M D INC

MEDICARE: DENNIS JORDANIDES M D INC
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
1207R00000XInternal Medicine PhysicianA66293CA

General Provider Information

NPI Number : 1326318155
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENNIS JORDANIDES M D INC
Provider Business Mailing Address
First Line : 500 SUPERIOR AVE
Second Line : SUITE # 135
City : NEWPORT BEACH
State : CA
Zip : 92663-3657
Country : US
Telephone Number : 949-764-7305
Fax Number : 949-764-7306
Provider Business Practice Location Address
First Line : 320 SUPERIOR AVE STE 200
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92663-2741
Country : US
Telephone Number : 949-764-7305
Fax Number : 949-764-7306
Authorized Official
Title or Position : PRESIDENT
Name : DENNIS JORDANIDES
Credential : MD
Telephone Number : 949-764-7305
Provider Enumeration Date : 01/10/2012
Last Update Date : 05/20/2024

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Directions to “DENNIS JORDANIDES M D INC ” Practice Location

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