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Individual
JORDAN SMITH
Active
Individual
JORDAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
105202
CA
390200000X
Student in an Organized Health Care Education/Training Program
14402
CA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
DDS105202
CA
Other
Enumeration date
04/27/2020
Last updated
05/15/2026
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