Individual
DR. JASON IRA HEIDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6268 NORTH UNIVERSITY DRIVE, TAMARAC, FL 33321
(732) 947-8445
Mailing address
4020 N HILLS DR APT 39, HOLLYWOOD, FL 33021-2447
(732) 947-8445
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN26992
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/02/2021
Last updated
06/21/2023
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