Provider Demographics
NPI:1992008080
Name:MORGAN, JASON H (DDS)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:H
Last Name:MORGAN
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 1:1502 E COLLINS AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-5934
Mailing Address - Country:US
Mailing Address - Phone:208-229-0403
Mailing Address - Fax:
Practice Address - Street 1:1502 E COLLINS AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867
Practice Address - Country:US
Practice Address - Phone:714-744-2060
Practice Address - Fax:714-744-2066
Is Sole Proprietor?:No
Enumeration Date:2010-12-10
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50648122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist