Provider Demographics
NPI:1346941234
Name:OZCAN, JORDAN (DMD)
Entity type:Individual
Prefix:MR
First Name:JORDAN
Middle Name:
Last Name:OZCAN
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 1:515 DELAWARE ST SE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0357
Mailing Address - Country:US
Mailing Address - Phone:612-624-8600
Mailing Address - Fax:612-624-2669
Practice Address - Street 1:515 DELAWARE ST SE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0357
Practice Address - Country:US
Practice Address - Phone:612-624-8600
Practice Address - Fax:612-624-2669
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2025-06-05
Deactivation Date:2023-10-19
Deactivation Code:
Reactivation Date:2023-11-13
Provider Licenses
StateLicense IDTaxonomies
MNR8951223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery