Provider Demographics
NPI:1942986823
Name:CHANLEY, JORDYNE LYNZEE (DDS)
Entity type:Individual
Prefix:DR
First Name:JORDYNE
Middle Name:LYNZEE
Last Name:CHANLEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 MONMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08030-1502
Mailing Address - Country:US
Mailing Address - Phone:856-386-1174
Mailing Address - Fax:
Practice Address - Street 1:535 MONMOUTH ST
Practice Address - Street 2:
Practice Address - City:GLOUCESTER CITY
Practice Address - State:NJ
Practice Address - Zip Code:08030-1502
Practice Address - Country:US
Practice Address - Phone:856-386-1174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0449561223G0001X
NJ22DI030517001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice