IndividualActive
David Jardenil, D.D.S.
NPI 1366512832 · Oral and Maxillofacial Surgery (Dentist) · Portage, IN
Provider details
- NPI number
- 1366512832
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- No
- License
- 12008911 (IN)
Specialties & taxonomies
Dental Providers
Practice location
3204 Lancer St
Ste. B
Portage, IN 46368-4490
Phone: (219) 762-1806
Fax: (219) 763-9979
Approximate (ZIP-level) locationGet directions
Mailing address
3204 Lancer St
Portage, IN 46368-4490
Registry dates
- Enumerated
- 2006-11-09
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.