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ELLIS BURKE JARDINE DMD PC NPI 1720458359


NPI Information

NPI: 1720458359
Provider Name: ELLIS BURKE JARDINE, DMD, PC

Doing Business As: ADVANCED DENTAL SPECIALISTS

Classification: Dentist - 1223P0700X
Entity Type: Organization

Specialization: Prosthodontics

Address:
406 SE 131ST AVE STE 305
VANCOUVER, WA
ZIP 98683
Phone: (360) 253-9792
Get Directions

ELLIS BURKE JARDINE, DMD, PC is a prosthodontics dentist in Vancouver, WA. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. ELLIS BURKE JARDINE, DMD, PC NPI is 1720458359. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Advanced Dental Specialists.

The provider's business location address is:

406 SE 131ST AVE STE 305
VANCOUVER, WA
ZIP 98683-014
Phone: (360) 253-9792
Fax: (360) 604-5266

The provider's authorized official is Ellis Burke Jardine .
The authorized official title is Owner and has the following contact phone number (360) 253-9792.

The enumeration date for this NPI number is 9/24/2015 and was last updated on 3/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223P0700XDentistProsthodontics60339865WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1WA 60339865OTHERWASHINGTONWA DENTAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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