# JOURDAN FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447426317
- **Authorized official:** THOMAS B JOURDAN D.D.S. (DENTIST)
- **Authorized official phone:** (918) 256-6831

## Contact information

- **Practice address:** 120A W DELAWARE AVE, VINITA, OK 74301-4224
- **Practice address phone:** (918) 256-6831
- **Mailing address:** 120A W DELAWARE AVE, VINITA, OK 74301-4224
- **Mailing address phone:** (918) 256-6831

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 5381 | OK | Yes |

## Other

- **Enumeration date:** 05/01/2008
- **Last updated:** 05/01/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 263477085001 | BLUE CROSS BLUE SHIELD | OK |
| 01 | — | 803040C | UNITED CONCORDIA | OK |
| 01 | — | OK5381 | DELTA DENTAL | OK |