Provider Demographics
NPI:1699953364
Name:JOURDAN AND GIANNINI DENTAL
Entity type:Organization
Organization Name:JOURDAN AND GIANNINI DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:F
Authorized Official - Last Name:GIANNINI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-485-4997
Mailing Address - Street 1:9146 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60513-1304
Mailing Address - Country:US
Mailing Address - Phone:708-485-4997
Mailing Address - Fax:708-485-2611
Practice Address - Street 1:9146 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:IL
Practice Address - Zip Code:60513-1304
Practice Address - Country:US
Practice Address - Phone:708-485-4997
Practice Address - Fax:708-485-2611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty