Individual
LAUREN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
004995
OH
122300000X
Dentist
Primary
019036994
IL
390200000X
Student in an Organized Health Care Education/Training Program
004995
OH
Other
Enumeration date
06/18/2025
Last updated
08/04/2026
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