Provider Demographics
NPI:1003344300
Name:TELIN, JORDAN JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:JOSEPH
Last Name:TELIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 QUEENSBERRY ST APT A
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-4717
Mailing Address - Country:US
Mailing Address - Phone:412-992-0783
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE # HU-421
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-2224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program