Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jordan Chelsey Douglas

Individual provider Dentist · NPI 1063011799

Jordan Chelsey Douglas is a Dentist in Corona, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2020
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Practice location Address checks out

460 N McKinley St
Corona, CA 92879-3405
Phone: (951) 531-9693
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 105748 (CA)

Record details

NPI number1063011799
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 23, 2020
Last updated in NPPESOctober 23, 2020
Certification dateOctober 23, 2020

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