Individual
DR. DENNIS T JORDANIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 SUPERIOR AVE, SUITE 135, NEWPORT BEACH, CA 92663-3657
(949) 734-7446
(949) 734-7448
Mailing address
500 SUPERIOR AVE STE 135, NEWPORT BEACH, CA 92663-3617
(949) 734-7446
(949) 734-7448
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A66293
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A66293
BLUE SHEILD OF CALIFORNIA
CA
05
—
00A66293
—
CA
01
—
P00471216
MEDICARE RAIL ROAD
CA
Enumeration date
06/09/2005
Last updated
08/22/2014
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