Provider Demographics
NPI:1346941234
Name:OZCAN, JORDAN (DMD)
Entity Type:Individual
Prefix:MR
First Name:JORDAN
Middle Name:
Last Name:OZCAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UW DEPARTMENT OF ORAL SURGERY
Mailing Address - Street 2:1959 NE PACIFIC STREET
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195
Mailing Address - Country:US
Mailing Address - Phone:206-300-2609
Mailing Address - Fax:
Practice Address - Street 1:UW DEPARTMENT OF ORAL SURGERY
Practice Address - Street 2:1959 NE PACIFIC STREET
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195
Practice Address - Country:US
Practice Address - Phone:206-300-2609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2023-11-13
Deactivation Date:2023-10-19
Deactivation Code:
Reactivation Date:2023-11-13
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program