Individual
DR. JED C. NORDFELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
6351 W 13400 S, HERRIMAN, UT 84096-5790
(801) 302-1045
Mailing address
4361 S PERIGRINE WAY, WEST VALLEY CITY, UT 84120-5304
(502) 759-9613
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
056200
NY
1223P0221X
Pediatric Dentistry
Primary
9474332-9922
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871888735
—
NY
05
—
1871888735
—
UT
Enumeration date
06/17/2011
Last updated
08/25/2015
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