Provider Demographics
NPI:1205046299
Name:NORDLANDER, JEFFREY YNGVE (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:YNGVE
Last Name:NORDLANDER
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 1:6409 FOLSOM BLVD # 2
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-4620
Mailing Address - Country:US
Mailing Address - Phone:916-454-0855
Mailing Address - Fax:
Practice Address - Street 1:6409 FOLSOM BLVD # 2
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-4620
Practice Address - Country:US
Practice Address - Phone:916-454-0855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307821223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics