Provider Demographics
NPI:1730315664
Name:JANGAARD, NOLAN SPENCER (DDS)
Entity Type:Individual
Prefix:
First Name:NOLAN
Middle Name:SPENCER
Last Name:JANGAARD
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 OSBORN ST
Mailing Address - Street 2:SUITE #120
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-8656
Mailing Address - Country:US
Mailing Address - Phone:949-551-2024
Mailing Address - Fax:949-551-9594
Practice Address - Street 1:2 OSBORN ST
Practice Address - Street 2:SUITE #120
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-8656
Practice Address - Country:US
Practice Address - Phone:949-551-2024
Practice Address - Fax:949-551-9594
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA581431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice