Provider Demographics
NPI:1548607344
Name:ZINGERMAN, JORDAN JAMES (DMD)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:JAMES
Last Name:ZINGERMAN
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 1:2921 5TH AVE NE STE 110
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-7044
Mailing Address - Country:US
Mailing Address - Phone:253-841-3173
Mailing Address - Fax:253-841-0210
Practice Address - Street 1:2921 5TH AVE NE STE 110
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-7044
Practice Address - Country:US
Practice Address - Phone:253-841-3173
Practice Address - Fax:253-841-0210
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60368386122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist