Provider Demographics
NPI:1407867633
Name:LINDEN, JEFFERY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:
Last Name:LINDEN
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 1:2 EXECUTIVE CT
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9507
Mailing Address - Country:US
Mailing Address - Phone:847-277-9911
Mailing Address - Fax:847-277-9922
Practice Address - Street 1:2 EXECUTIVE CT
Practice Address - Street 2:SUITE 102
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9507
Practice Address - Country:US
Practice Address - Phone:847-277-9911
Practice Address - Fax:847-277-9922
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics