Provider Demographics
NPI:1962582759
Name:HARDEN, JAN RAYMOND (DDS)
Entity type:Individual
Prefix:DR
First Name:JAN
Middle Name:RAYMOND
Last Name:HARDEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2539 S GESSNER RD
Mailing Address - Street 2:#1
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2034
Mailing Address - Country:US
Mailing Address - Phone:713-784-4050
Mailing Address - Fax:713-784-5035
Practice Address - Street 1:2539 S GESSNER RD
Practice Address - Street 2:#1
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2034
Practice Address - Country:US
Practice Address - Phone:713-784-4050
Practice Address - Fax:713-784-5035
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice