Provider Demographics
NPI:1780716878
Name:BORANDI, JEFFREY JAMES (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:JAMES
Last Name:BORANDI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10154 WOODBURY DRIVE
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090
Mailing Address - Country:US
Mailing Address - Phone:724-759-7948
Mailing Address - Fax:724-759-7952
Practice Address - Street 1:207 EMERSON DR
Practice Address - Street 2:
Practice Address - City:ZELIENOPLE
Practice Address - State:PA
Practice Address - Zip Code:16063-1406
Practice Address - Country:US
Practice Address - Phone:724-452-7887
Practice Address - Fax:724-452-6803
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS036141122300000X, 1223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology
No122300000XDental ProvidersDentist