Provider Demographics
NPI:1093919268
Name:JASON H NORDEAN
Entity Type:Organization
Organization Name:JASON H NORDEAN
Other - Org Name:TODAYS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEISNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-844-0777
Mailing Address - Street 1:570 SE BASELINE ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4114
Mailing Address - Country:US
Mailing Address - Phone:503-844-0777
Mailing Address - Fax:503-648-9603
Practice Address - Street 1:570 SE BASELINE ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4114
Practice Address - Country:US
Practice Address - Phone:503-844-0777
Practice Address - Fax:503-648-9603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD8687122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR028155Medicaid