Provider Demographics
NPI:1053861765
Name:JORDAN A LAMBERTON DDS, INC
Entity Type:Organization
Organization Name:JORDAN A LAMBERTON DDS, INC
Other - Org Name:HELLO ORTHO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-226-5555
Mailing Address - Street 1:3270 BEARD RD
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3406
Mailing Address - Country:US
Mailing Address - Phone:707-226-5555
Mailing Address - Fax:
Practice Address - Street 1:3270 BEARD RD
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3406
Practice Address - Country:US
Practice Address - Phone:707-226-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA610541223X0400X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty