Provider Demographics
NPI:1730922410
Name:ROSSELL, JORDAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:
Last Name:ROSSELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:JORDAN
Other - Middle Name:
Other - Last Name:ROSSELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JORDAN ROSSELL DDS
Mailing Address - Street 1:1395 MCLAUGHLIN RUN RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-3101
Mailing Address - Country:US
Mailing Address - Phone:412-854-2310
Mailing Address - Fax:
Practice Address - Street 1:1395 MCLAUGHLIN RUN RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-3101
Practice Address - Country:US
Practice Address - Phone:412-854-2310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044692122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist