Provider Demographics
NPI:1407904915
Name:JORDEN, MONSERRAT (DMD)
Entity Type:Individual
Prefix:DR
First Name:MONSERRAT
Middle Name:
Last Name:JORDEN
Suffix:
Gender:F
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:NAS JACKSONVILLE
Mailing Address - Street 2:BUREAU OF MEDICINE & SURGERY DETACHMENT JACKSONVILL
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32212-0140
Mailing Address - Country:US
Mailing Address - Phone:877-772-4373
Mailing Address - Fax:
Practice Address - Street 1:NAS JACKSONVILLE
Practice Address - Street 2:BUREAU OF MEDICINE & SURGERY DETACHMENT JACKSONVILL
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32212-0140
Practice Address - Country:US
Practice Address - Phone:877-772-4373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX220721223G0001X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice