Provider Demographics
NPI:1396899258
Name:VORA, JAYANG MADHUKUMAR (DDS,MDS)
Entity type:Individual
Prefix:DR
First Name:JAYANG
Middle Name:MADHUKUMAR
Last Name:VORA
Suffix:
Gender:M
Credentials:DDS,MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9672 BALL RD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-5309
Mailing Address - Country:US
Mailing Address - Phone:714-772-0102
Mailing Address - Fax:714-772-8737
Practice Address - Street 1:9672, BALL ROAD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804
Practice Address - Country:US
Practice Address - Phone:714-772-0102
Practice Address - Fax:714-772-8737
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA278511223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics