Individual
MR. JASON H NORDEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4245 N 19TH AVE, PHOENIX, AZ 85015-5109
(602) 650-1700
Mailing address
4245 N 19TH AVE, PHOENIX, AZ 85015-5109
(602) 650-1700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D008657
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028155
OFFICE OF MEDICAL ASS
OR
05
—
028155
—
OR
Enumeration date
09/26/2006
Last updated
07/17/2024
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