Provider Demographics
NPI:1386975977
Name:JORDAN M STIRNEMAN, DDS, PLLC
Entity type:Organization
Organization Name:JORDAN M STIRNEMAN, DDS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:STIRNEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-795-5841
Mailing Address - Street 1:6800 WEST LOOP S
Mailing Address - Street 2:SUITE 550
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4528
Mailing Address - Country:US
Mailing Address - Phone:713-795-5841
Mailing Address - Fax:713-795-5596
Practice Address - Street 1:6800 WEST LOOP S
Practice Address - Street 2:SUITE 550
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4528
Practice Address - Country:US
Practice Address - Phone:713-795-5841
Practice Address - Fax:713-795-5596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX228131223G0001X
TX61791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty