Individual
DR. JOHN N ORDAHL SR.
Active
Individual
DR. JOHN N ORDAHL SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.M.S.
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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