Provider Demographics
NPI:1922784297
Name:JORDAN, HANNAH LEANN (DMD)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:LEANN
Last Name:JORDAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N LONGSTREET ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556-3303
Mailing Address - Country:US
Mailing Address - Phone:843-355-7606
Mailing Address - Fax:
Practice Address - Street 1:601 N LONGSTREET ST
Practice Address - Street 2:
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-3303
Practice Address - Country:US
Practice Address - Phone:843-355-7606
Practice Address - Fax:843-355-7506
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDGD.105471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice