Provider Demographics
NPI:1154513729
Name:SLOVAN, JARED (DMD)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:
Last Name:SLOVAN
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 1:4427 S RURAL RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7061
Mailing Address - Country:US
Mailing Address - Phone:480-897-2274
Mailing Address - Fax:
Practice Address - Street 1:4427 S RURAL RD
Practice Address - Street 2:SUITE 2
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7061
Practice Address - Country:US
Practice Address - Phone:480-897-2274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4358122300000X
AZ8919122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist