Scott Richard Jordan, DMD

NPI #1639866213 in Middleton, Idaho

Provider Information

NPI Number: 1639866213
Entity Type: Individual
Name: Scott Richard Jordan, DMD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Apr 24, 2023
Last Updated: Jun 23, 2025

Practice Location

Address: 201 S PARADISE AVE
City: Middleton
State: Idaho
ZIP Code: 83644-5809
Phone: (208) 585-0048

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary
Student in an Organized Health Care Education/Training Program	390200000X

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