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Individual
DR. JORDAN CIMILLUCA
Active
Individual
DR. JORDAN CIMILLUCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
00205129
CO
122300000X
Dentist
70128025
WA
171000000X
Military Health Care Provider
Primary
00205129
CO
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
00205129
CO
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
70128025
WA
Other
Enumeration date
03/07/2022
Last updated
08/17/2026
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