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Provider Information for 1275945875



DR. JORDAN CORNELIO LUNA DDS

Gender: MALE

Individual NPI: 1275945875

Calendar   Last Updated:  2014-05-30
  Certification Date: 

Details

Name Value
NPI 1275945875
Enumeration Date 2014-05-30
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 192 S COLLINS RD STE 100
SUNNYVALE, TX 75182-4634
United States

Phone: 972-226-6655 | Fax:
View Map External Link
Primary Practice Address 192 S COLLINS RD STE 100
SUNNYVALE, TX 75182-4634
United States

Phone: 972-226-6655 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist TX 30002