Provider Demographics
NPI:1881231454
Name:JORDYN & TAYLOR FAMILY DENTAL, PLLC
Entity Type:Organization
Organization Name:JORDYN & TAYLOR FAMILY DENTAL, PLLC
Other - Org Name:PINNACLE PEAK DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:530-300-2200
Mailing Address - Street 1:36815 N BOULDER VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85262-3913
Mailing Address - Country:US
Mailing Address - Phone:530-300-2200
Mailing Address - Fax:
Practice Address - Street 1:8900 E PINNACLE PEAK RD STE D210
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3614
Practice Address - Country:US
Practice Address - Phone:480-659-9499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty