Jonathan Chodroff, MD, DDS, II, P.L.L.C.
Oral & Maxillofacial Surgery in Vancouver, WA. Organization (NPI-2).
NPI number1497547517
StatusActive
Last updated in NPPESMay 22, 2025
Details
- NPI
- 1497547517
- Entity type
- Organization (NPI-2)
- Legal business name
- Jonathan Chodroff, MD, DDS, II, P.L.L.C.
- Organization subpart
- No
- Enumeration date
- May 22, 2025
- Certification date
- May 22, 2025
- Last updated
- May 22, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 204E00000X | Oral & Maxillofacial Surgery | – | – | Yes |
Other names
- Lake River Oral And Facial Surgery (Doing Business As)
Practice location
14411 Ne 20th Ave Ste 111Vancouver, WA 98686-6433
Phone 360-425-7220
Mailing address
14411 Ne 20th Ave Ste 111Vancouver, WA 98686-6433
Phone 360-425-7220
Other practice locations
855 11th Ave Ste B
Longview, WA 98632-2461
Longview, WA 98632-2461
Phone 360-425-7220
Authorized official
Jonathan Daniel Chodroff
Oral Surgeon
3023793104
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