Individual
DR. JOHN N ORDAHL SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.M.S.
Contact information
Practice address
3505 AUSTIN BLUFFS PKWY SUIET 215, COLORADO SPRINGS, CO 80918
(719) 596-3098
(719) 596-3009
Mailing address
3505 AUSTIN BLUFFS PKWY SUIET 215, COLORADO SPRINGS, CO 80918
(719) 596-3098
(719) 596-3009
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5462
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005233146
AETNA DMO
CO
05
—
02054625
—
CO
05
—
1801027925
—
CO
01
—
794996
UNITED CONCORDIA
CO
Enumeration date
12/20/2005
Last updated
05/07/2021
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